Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nutrition, Education |
133NN1002X | |||
Health Educator |
174H00000X |
| NPI # | 1417404302 |
| LBN Legal business name | ELLEN J MATHESON FUNCTIONAL WELLNESS SOLUTIONS, LLC |
| Authorized official | ELLEN MATHESON - (CERTIFIED NUTRITION SPECIALIST) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/08/2016 |
| Last updated | 09/08/2016 - About 10 years ago |
| Identifiers | n/a |
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