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:
Health care specialties
| Specialty | Code | License # | 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 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356353452 | NPPES |
| Maine | Other | 11339866 | CAQH PROVIDER ID |
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