| NPI | 1235349002 |
|---|---|
| Former Name | DANIELLE DENESE MUCKLEROY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT3445) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |