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Individual
MRS. JACQUELYN EHRENBERG
Active
Individual
MRS. JACQUELYN EHRENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC, CES
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000134
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000006014
NATIONAL ATHLETIC TRAINERS' BOARD OF CERTIFICATION, INC
PA
Enumeration date
06/25/2016
Last updated
06/25/2016
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