| NPI | 1174912802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: WA NU 60507314) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA MC 60507166) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-19 |