Individual
ADRIENNE DANIELLE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330-0001
(818) 677-1200
Mailing address
7248 KELVIN AVE APT 13, WINNETKA, CA 91306-2766
(818) 389-1336
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2018
Last updated
02/28/2021
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