Individual
DANIELLE MOLLA LEYONMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
389 CONGRESS ST, ROOM 307, PORTLAND, ME 04101-3566
(207) 874-8784
(207) 874-8913
Mailing address
180 PARK AVE, FIRST FLOOR, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R057363
ME
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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