| NPI | 1487275285 |
|---|---|
| Other Name | KATIE M MAYBERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.004177) |
| Enumeration Date | 2020-05-03 |
| Last Update Date | 2020-05-03 |