| NPI | 1558014415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN RIEKER Owner/Registered Dietitian 317-508-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2022-02-01 |