| NPI | 1679043913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 164W00000X Licensed Practical Nurse (Licence: GA LPN094918) | |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2018-11-29 |