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Individual

CAROL JEAN REEDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LD

Contact information

Practice address
933 E PIERCE ST, COUNCIL BLUFFS, IA 51503-4626
(712) 396-7212
Mailing address
23 LOCUST LODGE AVE, COUNCIL BLUFFS, IA 51503-1663

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
00451
IA
133V00000X
Registered Dietitian
Primary
499883
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00451
IOWA DIETETIC LICENSE
IA
01
R499883
AMERICAN DIETETIC ASSOC
IA
Enumeration date
03/14/2007
Last updated
07/08/2007
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