Individual
KARI LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CNSC
Contact information
Practice address
636 ALLEN AVE, PORTLAND, ME 04103-3706
(801) 913-7349
Mailing address
636 ALLEN AVE, PORTLAND, ME 04103-3706
(801) 913-7349
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
6331040-4901
UT
133V00000X
Registered Dietitian
Primary
DI1318
ME
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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