Shanickwa Jackson Valid NPI

Individual provider · Athletic Trainer · Hattiesburg, MS

NPI

1326560319

Type

Individual (Type 1)

Primary specialty

Athletic Trainer (Specialist/Technologist)

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

2255A2300X

License number

AT0857 (MS)

Sex

Female

Sole proprietor

No

Enumerated

2017-07-11

Last updated

2017-07-11