Individual
CAROLYN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., RDN, LDN
Contact information
Practice address
3100 W ROLLING HILLS CIR UNIT 1, DAVIE, FL 33328-1949
(828) 817-2308
Mailing address
3100 W ROLLING HILLS CIR APT 107, DAVIE, FL 33328-1954
(828) 817-2308
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86155168
FL
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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