NPI | 1174791479 |
---|---|
Former Name | ABBY LYNN BANGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133N00000X Nutritionist (Licence: WA NU60058318) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60199461) |
Enumeration Date | 2008-02-20 |
Last Update Date | 2024-03-19 |