Provider Demographics
NPI:1831177542
Name:MAHER, MARIANNE (RD LDN)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:MAHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-0686
Mailing Address - Country:US
Mailing Address - Phone:508-595-0531
Mailing Address - Fax:508-829-5367
Practice Address - Street 1:45 CRANE AVENUE
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028
Practice Address - Country:US
Practice Address - Phone:413-525-7451
Practice Address - Fax:413-525-7459
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1434133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered