| NPI | 1669869590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEVONA PHONSENA ANDERSON Wellness Professional 443-939-7675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |