Individual
KACI GOODGAME
Active
Individual
KACI GOODGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
LDN0000003000
TN
133V00000X
Registered Dietitian
LDN0000003000
TN
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
Update your record
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