Madore, Denise Lise

Madore, Denise Lise is an sole proprietor health care provider with primary practice located at 2 Colawicki Dr , North Yarmouth ME 04097-6752. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Madore, Denise Lise can be contacted via phone (804) 433-5682.

Contact Information

Primary practice address
2 Colawicki Dr North Yarmouth ME 04097-6752
Phone: (804) 433-5682
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X 871573 Virginia
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X

Profile Details

NPI number 1396955654
LBN Legal business name Madore, Denise Lise
Credentials RD, CSP, CNSC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2007
Last updated Jun 17th, 2011 - about 14 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 1396955654 NPPES
Virginia MEDICAID 004909976

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