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Individual

MISS MARA DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, CD-N, LDN

Contact information

Practice address
5901 KINGSTOWNE VILLAGE PKWY STE 300, ALEXANDRIA, VA 22315-5883
(860) 796-1930
Mailing address
95 BRETTON RD, MIDDLETOWN, CT 06457-4111
(860) 796-1930
(860) 545-3765

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
001415
CT
133V00000X
Registered Dietitian
919705
NC
133V00000X
Registered Dietitian
Primary
919705
VA

Other

Enumeration date
04/25/2011
Last updated
09/24/2018
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