Individual
REGAN MARIE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(512) 692-7045
Mailing address
705 KINGS WAY APT 1221, DEL RIO, TX 78840-2058
(570) 657-6426
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT88751
TX
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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