Donnelly, Judith

Donnelly, Judith is an sole proprietor health care provider with primary practice located at 805 Stevens Ave , Portland ME 04103-2626. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Donnelly, Judith can be contacted via phone (207) 772-6279.

Contact Information

Primary practice address
805 Stevens Ave Portland ME 04103-2626
Phone: (207) 772-6279
Fax: (207) 772-6279
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X D1433 Maine

Profile Details

NPI number 1356353452
LBN Legal business name Donnelly, Judith
Credentials R.D.,L.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 13th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356353452 NPPES
Maine Other 11339866 CAQH PROVIDER ID

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