| NPI | 1629660071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIMIE WINKLER Owner 617-855-5095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-08 |