| NPI | 1518499516 |
|---|---|
| Former Name | CELYSSE ELIZABETH MACKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: KY 04689) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208100000X Physical Medicine & Rehabilitation (Licence: KY 04689) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-10-05 |