| NPI | 1922429539 |
|---|---|
| Former Name | ALLYSSA RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001789) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2026-07-23 |