Individual
MRS. DIANNE COGBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN, MPH
Contact information
Practice address
721 CADIZ RD, VENICE, FL 34285-1618
(941) 223-1422
Mailing address
721 CADIZ RD, VENICE, FL 34285-1618
(941) 223-1422
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 529
FL
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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