| NPI | 1619165784 |
|---|---|
| Former Name | RENEE' MAE WENNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 1136) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA000517) |
| 225200000X Physical Therapy Assistant (Licence: NY 000706-1) | |
| Enumeration Date | 2007-10-14 |
| Last Update Date | 2007-10-14 |