| NPI | 1588795611 |
|---|---|
| Former Name | MARY STALEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI00001620) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OR LD-D-10234830) |
| 133V00000X Dietitian, Registered (Licence: TX DT88969) | |
| 133V00000X Dietitian, Registered (Licence: HI 399-LD) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2024-08-02 |