Individual
MARY ELLEN LAVANWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
2A CONSTITUTION AVE, HAMPDEN, ME 04444-1330
(207) 862-2303
(207) 862-2303
Mailing address
2A CONSTITUTION AVE, HAMPDEN, ME 04444-1330
(207) 862-2303
(207) 862-2303
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
3
NH
133V00000X
Registered Dietitian
Primary
DI877
ME
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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