| NPI | 1780225326 |
|---|---|
| Other Name | ST AGNES DIABETES PREVENTION PROGRAM |
| Entity Type | Organization |
| Authorized Contact | EDWARD R LOVERN President/CEO 667-234-2105 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| Additional Taxonomies | 101Y00000X Counselor |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2021-06-23 |