Individual
SHANNON MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6505 MARKET ST, BOARDMAN, OH 44512-3457
(330) 746-8100
Mailing address
875 AFTON AVE, YOUNGSTOWN, OH 44512-2404
(724) 301-6913
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86079255
—
133VN1004X
Pediatric Nutrition Registered Dietitian
86079255
—
Other
Enumeration date
06/20/2025
Last updated
06/20/2025
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