| NPI | 1316477813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOSHA WILDER YOUNG Owner/Manager 662-836-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MS D1613) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: MS D1613) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |