Individual
CAROLYN IRENE DEWANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
253 SEAMIST CT, PONTE VEDRA BEACH, FL 32082-4039
(904) 610-1640
Mailing address
253 SEAMIST CT, PONTE VEDRA BEACH, FL 32082-4039
(904) 610-1640
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4002
FL
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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