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Organization
PURELY ROOTED NUTRITION AND WELLNESS
Active
Organization
PURELY ROOTED NUTRITION AND WELLNESS
Active
Other names
Purely Rooted Nutrition and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHRYN GOWDY MS, CNS, LDN, CHHP (CLINICAL NUTRITIONIST)
(814) 777-8919
Entity
Organization
Contact information
Practice address
850 GALEN DR, STATE COLLEGE, PA 16803-1164
(814) 777-8919
Mailing address
850 GALEN DR, STATE COLLEGE, PA 16803-1164
(814) 777-8919
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
NULL
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
Primary
—
NULL
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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