Individual
CEASIA RENAE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 RIDGEVIEW DR, CHICKASAW, AL 36611-1317
(251) 361-8621
Mailing address
18 RIDGEVIEW DR, CHICKASAW, AL 36611-1317
(251) 361-8621
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
AL
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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