NPI | 1225097959 |
---|---|
Former Name | JENNIFER JOY HARDIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001164) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 1999135153) |
Enumeration Date | 2006-03-21 |
Last Update Date | 2020-04-21 |