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Individual

CHERESSE KINCAID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
801 LAURENCE DR, RHHS ATHLETICS, ROCKWALL, TX 75032-1953
(972) 822-8869
Mailing address
1050 WILLIAMS ST, ROCKWALL ISD ATHLETICS, ROCKWALL, TX 75087-2600

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000009769
TX
2255A2300X
Athletic Trainer
AT6136
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000009769
NATABOC
01
AT6136
LISCENCED ATHLETIC TRAINER
TX
Enumeration date
01/26/2015
Last updated
01/26/2015
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