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Individual

CARISSA NOELLE GAASCHE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, LDN

Contact information

Practice address
714 N CHADWICK ST UNIT 2, PHILADELPHIA, PA 19130-2862
(610) 389-9573
Mailing address
714 N CHADWICK ST UNIT 2, PHILADELPHIA, PA 19130-2862
(610) 389-9573

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN007360
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86105418
CDR
PA
01
DN007360
PALS
PA
Enumeration date
03/22/2022
Last updated
03/22/2022
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