| NPI | 1386180073 |
|---|---|
| Former Name | RILEY ALYSE KENNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MT ATR-LAT-LIC1574) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MT 80765) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT 80765) | |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2023-01-10 |