Individual
MISS NICOLE LENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RYT-200
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
CA
172M00000X
Mechanotherapist
Primary
—
CA
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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