Individual
KELLY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, MS
Contact information
Practice address
225 TOWN SQUARE DR, LUSBY, MD 20657-6534
(610) 952-7881
Mailing address
48346 LONG LN, LEXINGTON PARK, MD 20653-4527
(610) 952-7881
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
PA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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