| NPI | 1568147874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY FUNAIR Owner 724-900-9075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 174400000X Specialist |
| 174H00000X Health Educator | |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-09-12 |