| NPI | 1700972460 |
|---|---|
| Former Name | GLENYS S PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT05235) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-09 |