Provider Demographics
NPI:1154935559
Name:MOWRY, DANIELLE CLAIRE (MS, RDN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CLAIRE
Last Name:MOWRY
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:CLAIRE
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7027
Mailing Address - Country:US
Mailing Address - Phone:207-795-5984
Mailing Address - Fax:
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7041
Practice Address - Country:US
Practice Address - Phone:207-795-5984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN01076133V00000X
MEDL1864133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered