| NPI | 1801923024 |
|---|---|
| Former Name | HEATHER MATLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CA 810452) |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2023-09-11 |