Individual
MISS MARY DALE CORNETTA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LDN, RD
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 327-4072
(318) 327-4941
Mailing address
3100 DEBORAH DR, MONROE, LA 71201-2092
(318) 537-3058
(318) 327-4941
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1735
LA
Other
Enumeration date
09/14/2005
Last updated
07/08/2007
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