Individual
MS. JACQUELINE FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
117 ELM ST, WEST ORANGE, NJ 07052-5816
(973) 731-4971
Mailing address
117 ELM ST, WEST ORANGE, NJ 07052-5816
(973) 731-4971
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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