| NPI | 1003461609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA COUGHENOUR Owner 252-455-2805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |