Individual
MARY ANN STOCKHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
917 NEWPORT RD, UTICA, NY 13502
(315) 572-0877
Mailing address
917 NEWPORT RD, UTICA, NY 13502
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
009596
NY
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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