Individual
COLLEEN DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., RD, LD, M.A.
Contact information
Practice address
105 WAXBERRY CIR, COLUMBIA, SC 29201-1424
(803) 394-1171
Mailing address
105 WAXBERRY CIR, COLUMBIA, SC 29201-1424
(803) 394-1171
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
100
SC
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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