| NPI | 1801324850 |
|---|---|
| Other Name | WYNEISHA JACKEE' MCINTOSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IL 096-004012) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2017-06-02 |