Provider Demographics
NPI:1689169435
Name:GAUTHIER, GINA (RD, LDN)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:GAUTHIER
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 1:350 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2122
Mailing Address - Country:US
Mailing Address - Phone:804-839-6610
Mailing Address - Fax:
Practice Address - Street 1:5812 LOWER YORK ROAD
Practice Address - Street 2:
Practice Address - City:LAHASKA
Practice Address - State:PA
Practice Address - Zip Code:18931
Practice Address - Country:US
Practice Address - Phone:215-794-7880
Practice Address - Fax:215-794-7884
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist