| NPI | 1184197816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER N MAHONEY Owner/Registered Dietitian 314-605-3287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |