Provider Demographics
NPI:1578381349
Name:COLLINS, MARGARETE (RDN)
Entity type:Individual
Prefix:MRS
First Name:MARGARETE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:MARGARETE
Other - Middle Name:
Other - Last Name:DE MACEDO CARNEIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:1087 SHADY MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:AR
Mailing Address - Zip Code:72039-8166
Mailing Address - Country:US
Mailing Address - Phone:909-653-7106
Mailing Address - Fax:
Practice Address - Street 1:1087 SHADY MEADOW RD
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:AR
Practice Address - Zip Code:72039-8166
Practice Address - Country:US
Practice Address - Phone:909-653-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DX5139133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered