Individual
MS. TRACY NICOLE GOTTSCHALK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETITIAN
Contact information
Practice address
309 ORANGE RD, MONTCLAIR, NJ 07042-4451
(908) 230-7648
(888) 649-4924
Mailing address
49 BEVERLY RD, MONTCLAIR, NJ 07043-2401
(908) 230-7648
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86058451
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
02/05/2020
Last updated
12/11/2024
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