Individual
MYA-ANN TAKARA TSCHOPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19 CHRIS DR, UNCASVILLE, CT 06382-1138
(860) 367-0036
Mailing address
19 CHRIS DR, UNCASVILLE, CT 06382-1138
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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