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Individual

TRACEY CAVALLARO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.D.

Contact information

Practice address
10200 FOREST GREEN BLVD, SUITE 112, LOUISVILLE, KY 40223-5165
(502) 640-6015
Mailing address
10200 FOREST GREEN BLVD, SUITE 112, LOUISVILLE, KY 40223-5165

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1132
KY

Other

Enumeration date
05/21/2013
Last updated
08/23/2013
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