Provider Demographics
NPI:1538985502
Name:HOWARD, MARY (RDN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-4447
Mailing Address - Country:US
Mailing Address - Phone:773-906-4773
Mailing Address - Fax:
Practice Address - Street 1:2810 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4447
Practice Address - Country:US
Practice Address - Phone:773-906-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLRD.2243133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered