| NPI | 1801908447 |
|---|---|
| Former Name | AMY CYNTHIA GLEASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MA 2055) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-05-14 |