| NPI | 1225648397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JEAN BARBOZA Fitness & Nutrition Specialist 774-379-9761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133NN1002X Nutritionist Nutrition, Education |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-08-04 |