Individual
MRS. SHANNON LYN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
2400 SOUTH ST, GREATER LAFAYETTE HEALTH SERVICES FOOD AND NUTRITION, LAFAYETTE, IN 47904-3027
(765) 449-5139
(765) 449-3061
Mailing address
7392 W DIVISION LINE RD, DELPHI, IN 46923-8909
(765) 564-3650
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
848411
IN
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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