Provider Demographics
NPI:1437664513
Name:SKWER, GRETCHEN (RD, LDN)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:SKWER
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 DILLON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-1714
Mailing Address - Country:US
Mailing Address - Phone:610-331-8338
Mailing Address - Fax:
Practice Address - Street 1:1309 DILLON RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-1714
Practice Address - Country:US
Practice Address - Phone:610-331-8338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered