Individual
MISS NAOMI RUTH FAWCETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1009 W SEMANDS ST, CONROE, TX 77301-1643
(936) 203-6047
Mailing address
1009 W SEMANDS ST, CONROE, TX 77301-1643
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
609
OK
390200000X
Student in an Organized Health Care Education/Training Program
609
OK
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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