| NPI | 1336486653 |
|---|---|
| Former Name | LYNN M MATTINGLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KY 724766) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: KY 0797) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |