Individual
ANDREA PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.N., L.D.
Contact information
Practice address
33 TUCKER AVE, PORTLAND, ME 04103-1422
(207) 468-3074
Mailing address
33 TUCKER AVE, PORTLAND, ME 04103-1422
(207) 468-3074
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI1163
ME
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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