| NPI | 1366543977 |
|---|---|
| Former Name | REBECCA A POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 919) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 000664-1) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2013-11-15 |