Individual
CARLY HEYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
620 N LAKE AVE, PASADENA, CA 91101-1220
(626) 793-7350
Mailing address
7777 W 91ST ST, UNIT B2159, PLAYA DEL REY, CA 90293-8310
(860) 655-9316
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1095018
CT
Other
Enumeration date
08/25/2016
Last updated
10/16/2018
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