| NPI | 1285779264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 11459) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC lc3000745) |
| 133N00000X Nutritionist (Licence: DC 0000060) | |
| 133N00000X Nutritionist (Licence: DC n00012) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |