| NPI | 1033629175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEA JOHANNA CREGUT Owner 805-738-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2020-08-11 |