Individual
MS. SEANNA MALIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3601 COUNTRY CLUB RD, ALLENTOWN, PA 18103-6984
(610) 737-5702
Mailing address
3601 COUNTRY CLUB RD, ALLENTOWN, PA 18103-6984
(610) 737-5702
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004376
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050802041
NATA CERTIFICATION
PA
01
—
RT004376
PENNSYLVANIA STATE LICENSE FOR ATHLETIC TRAINER
PA
Enumeration date
12/17/2011
Last updated
12/17/2011
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