| NPI | 1144762071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY M BOUCHARD Registered Dietitian/Owner 207-331-2381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ME DI1016) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |