Provider Demographics
NPI:1164390340
Name:TRUETT, CARLY (RDN)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:TRUETT
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1928
Mailing Address - Country:US
Mailing Address - Phone:856-617-1012
Mailing Address - Fax:856-502-0100
Practice Address - Street 1:116 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1928
Practice Address - Country:US
Practice Address - Phone:856-617-1012
Practice Address - Fax:856-502-0100
Is Sole Proprietor?:No
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered