Individual
ALYSSA LYNNE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
75 MARKET ST STE 304, PORTLAND, ME 04101-5040
(207) 400-6188
Mailing address
10 LINDY LN, FREEPORT, ME 04032-6338
(516) 816-1086
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI1393
ME
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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