NPI | 1720419393 |
---|---|
Former Name | JESSICA ANN HICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164.006090) |
Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: IL 164.006090) |
133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: IL 164.006090) | |
Enumeration Date | 2013-12-09 |
Last Update Date | 2019-10-29 |