Individual
MARCIA FASTABEND PELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD/N, CDE
Contact information
Practice address
2337 JUDSON ST, LYNN HAVEN, FL 32444-3018
(850) 867-0336
Mailing address
2337 JUDSON ST, LYNN HAVEN, FL 32444-3018
(850) 867-0336
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 3263
FL
Other
Enumeration date
01/09/2009
Last updated
02/24/2014
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