| NPI | 1912875568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKYRA TATYANA MARTIN Owner 803-341-8329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133N00000X Nutritionist |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 174H00000X Health Educator | |
| 226300000X Kinesiotherapist | |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |