Individual
MACKENZIE ANN SOUCHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
640 HILL DR, BRICK, NJ 08724-1122
(908) 910-1310
Mailing address
640 HILL DR, BRICK, NJ 08724-1122
(908) 910-1310
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86342510
CDR
—
Enumeration date
12/05/2024
Last updated
12/05/2024
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