Provider Demographics
NPI:1770827644
Name:OSTRYE, MAISIE LABRIE (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:MS
First Name:MAISIE
Middle Name:LABRIE
Last Name:OSTRYE
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LONE PINE LN
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6119
Mailing Address - Country:US
Mailing Address - Phone:617-448-9817
Mailing Address - Fax:
Practice Address - Street 1:9 LONE PINE LN
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6119
Practice Address - Country:US
Practice Address - Phone:617-448-9817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DI1962133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered