| NPI | 1982080396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON J BLAKENEY Owner 214-763-8410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT81052) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT81052) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2015-08-07 |