Individual
NICOLE KARMAE CHARBONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3893
Mailing address
5997 HARRELL PL APT B, FORT POLK, LA 71459-3687
(337) 531-2068
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06681
TX
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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