Provider Demographics
NPI:1982575171
Name:CORRIGAN, CYNTHIA JEANNE (RD LD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JEANNE
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12603 ALSTROEMERIA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5632
Mailing Address - Country:US
Mailing Address - Phone:210-428-8798
Mailing Address - Fax:
Practice Address - Street 1:12603 ALSTROEMERIA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-5632
Practice Address - Country:US
Practice Address - Phone:210-428-8798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT-80911133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty