Individual
HEATHER MUNNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NTP
Contact information
Practice address
683 S NARDO AVE APT D10, SOLANA BEACH, CA 92075-2324
(508) 364-2028
Mailing address
683 S NARDO AVE APT D10, SOLANA BEACH, CA 92075-2324
(508) 364-2028
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
CA
171400000X
Health & Wellness Coach
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93874353G08102
—
CA
Enumeration date
10/13/2021
Last updated
10/13/2021
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