| NPI | 1942922042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRANDON JOHNSON Attorney 270-993-9537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133V00000X Dietitian, Registered | |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric | |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management | |
| 171400000X Health & Wellness Coach | |
| 171M00000X Case Manager/Care Coordinator | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 2080B0002X Pediatrics, Obesity Medicine | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 2084B0002X Psychiatry & Neurology, Bariatric Medicine | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 246ZB0600X Specialist/Technologist, Other, Biostatistician | |
| 247000000X Technician, Health Information | |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2022-09-15 |