| NPI | 1962988543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: 724462) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: 724462) |
| 174H00000X Health Educator | |
| 2080B0002X Pediatrics, Obesity Medicine (Licence: NY 724462) | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 217003387) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |