| NPI | 1568735322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: WA NU60275126) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60243915) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2014-05-21 |