Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 12159 | CA |
NPI | 1467725424 |
---|---|
Provider Name | Joy Lynn Freeman |
First Address | Ojai, CA 93023-3808 |
Second Address | Ojai, CA 93023-3808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2012 |
Last Update Date | 21/02/2012 |