Provider Demographics
NPI:1538449582
Name:SNOCK, CAROLYN BETH (RD, LDN, CNSC)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:BETH
Last Name:SNOCK
Suffix:
Gender:F
Credentials:RD, LDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WESTBROOK DR
Mailing Address - Street 2:APT B11
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2487
Mailing Address - Country:US
Mailing Address - Phone:919-390-5155
Mailing Address - Fax:
Practice Address - Street 1:201 WESTBROOK DR
Practice Address - Street 2:APT B11
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2487
Practice Address - Country:US
Practice Address - Phone:919-390-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002917133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered