| NPI | 1255130217 |
|---|---|
| Former Name | CARLY CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: OH LD.09989) |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-03-12 |