Provider Demographics
NPI:1982868261
Name:TRUTE, JOAN (MA, RD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:TRUTE
Suffix:
Gender:F
Credentials:MA, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1606
Mailing Address - Country:US
Mailing Address - Phone:313-881-9366
Mailing Address - Fax:313-881-9366
Practice Address - Street 1:2100 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1606
Practice Address - Country:US
Practice Address - Phone:313-881-9366
Practice Address - Fax:313-881-9366
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIR718686133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered