Individual
MARY JANE CONDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
219 SUMMER TANAGER DR, RAVENEL, SC 29470-9672
(804) 239-2811
Mailing address
219 SUMMER TANAGER DR, RAVENEL, SC 29470-9672
(804) 239-2811
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD1557
SC
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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