Individual
MS. MARY E GAEKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
19601 MARINER AVE, TORRANCE, CA 90503-1647
(310) 371-0813
(310) 371-6851
Mailing address
19601 MARINER AVE, TORRANCE, CA 90503-1647
(310) 371-0813
(310) 371-6851
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
456483
AMERICAN DIETETIC ASSOCIA
—
Enumeration date
12/11/2007
Last updated
12/11/2007
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