Individual
MS. KATERYNA VADIMOVNA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D
Contact information
Practice address
135 GROVE ST, BANGOR, ME 04401-4007
(207) 299-4940
Mailing address
135 GROVE ST, BANGOR, ME 04401-4007
(207) 299-4940
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI952
ME
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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