Provider Demographics
NPI:1275866477
Name:GRETCHEN STALTERS,RD NUTRITION CONSULTING,INC
Entity Type:Organization
Organization Name:GRETCHEN STALTERS,RD NUTRITION CONSULTING,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:STALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:508-285-9383
Mailing Address - Street 1:7 STONY FIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-1145
Mailing Address - Country:US
Mailing Address - Phone:508-285-9383
Mailing Address - Fax:508-285-9383
Practice Address - Street 1:7 STONY FIELD RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1145
Practice Address - Country:US
Practice Address - Phone:508-285-9383
Practice Address - Fax:508-285-9383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-07
Last Update Date:2009-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2464133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty