Mariah Ellen Stuart
Specialist/Technologist, Athletic Trainer in Berea, KY. Individual provider (NPI-1).
NPI number1164048518
StatusActive
Last updated in NPPESNov 27, 2023
Details
- NPI
- 1164048518
- Entity type
- Individual (NPI-1)
- Name
- Mariah Ellen Stuart
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 22, 2020
- Certification date
- Jun 22, 2020
- Last updated
- Nov 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
101 Chestnut StBerea, KY 40403-1516
Phone 859-985-4156
Mailing address
814 Ridgewood Dr # 2Berea, KY 40403-9814
Phone 509-481-0751
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