Individual
MS. MICHELLE TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1100 AVENUE AT PORT IMPERIAL APT 910, WEEHAWKEN, NJ 07086-6303
(201) 704-4654
Mailing address
1100 AVENUE AT PORT IMPERIAL APT 910, WEEHAWKEN, NJ 07086-6303
(201) 704-4654
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
NJ
Other
Enumeration date
06/21/2016
Last updated
11/10/2020
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