Provider Demographics
NPI:1194183707
Name:GARONI, CARSON SUZANNE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:CARSON
Middle Name:SUZANNE
Last Name:GARONI
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:CARSON
Other - Middle Name:SUZANNE
Other - Last Name:GARONI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:PO BOX 3471
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27515-3471
Mailing Address - Country:US
Mailing Address - Phone:919-795-2233
Mailing Address - Fax:
Practice Address - Street 1:101 BOTANICAL WAY
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9270
Practice Address - Country:US
Practice Address - Phone:919-795-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003894133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered