| NPI | 1699203901 |
|---|---|
| Former Name | STACEE MAIRE ROUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY TCA518) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2017-05-31 |