| NPI | 1558689604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: PA DN005995) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2017-02-23 |