Individual
MRS. AVIS SCHOELEN DOMINGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD,LDN,CDE
Contact information
Practice address
501 MARTIN PREJEAN RD, CARENCRO, LA 70520-5219
(337) 886-7486
Mailing address
501 MARTIN PREJEAN RD, CARENCRO, LA 70520-5219
(337) 886-7486
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0761
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4C131
MEDICAL NUTRITION THERAPY
LA
Enumeration date
07/20/2006
Last updated
01/23/2008
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