Provider Demographics
NPI:1669830808
Name:LAWLER, MARNIE (NUTRITION THERAPY PR)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:
Last Name:LAWLER
Suffix:
Gender:F
Credentials:NUTRITION THERAPY PR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929-1301
Mailing Address - Country:US
Mailing Address - Phone:978-835-1733
Mailing Address - Fax:
Practice Address - Street 1:51 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MA
Practice Address - Zip Code:01929-1301
Practice Address - Country:US
Practice Address - Phone:978-835-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA001579133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education