NPI | 1487830998 |
---|---|
Former Name | ANDREA MARIE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AZ 851891) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AZ LPC-5184T) |
133V00000X Dietitian, Registered (Licence: MO 851891) | |
Enumeration Date | 2008-01-14 |
Last Update Date | 2011-06-17 |