Individual
CAROL ANN KOSTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3724 N LOYOLA DR APT 141, KENNER, LA 70065-7738
(504) 402-1190
Mailing address
3724 LOYOLA DRIVE, APT. 141, KENNER, LA 70065
(504) 402-1190
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
259
LA
133V00000X
Registered Dietitian
Primary
709045
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259
STATE OF LOUISIANA LICENSURE
LA
01
—
709045
REGISTRATION - ACADEMY OF NUTRITION AND DIETETICS
KY
Enumeration date
04/21/2016
Last updated
04/21/2016
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