Individual
MS. KAILEIGH M PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDE
Contact information
Practice address
900 BROADWAY BLDG 3, BANGOR, ME 04401
(207) 907-1187
(207) 907-1189
Mailing address
905 UNION ST STE 11, BANGOR, ME 04401-3039
(207) 973-7334
(207) 973-7424
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI1186
ME
133V00000X
Registered Dietitian
TD1145
ME
Other
Enumeration date
01/14/2013
Last updated
07/06/2018
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