| NPI | 1770078107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN A JACOBSEN Nutritionist/Owner 845-379-4616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2018-06-27 |