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Individual
ALYSSA RENAE WILLIAMS
Active
Individual
ALYSSA RENAE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
327128
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K03445639
DRIVER'S LICENSE
KS
Enumeration date
06/19/2021
Last updated
06/19/2021
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