DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARY EMBALABALA

Active Sole Proprietor

Student (Health Education/Training) · ATHENS, IL

Registration Details

NPI Number
1689133068
Provider Type
Individual
Gender
Female
NPI Issued
Mar 15, 2019 (7.1661496731904 yrs)
Last Updated
Mar 15, 2019
Sole Proprietor
Yes

Practice Information

Address
17586 KINCAID ST
ATHENS, IL, 626137574
Browse IL providers · Browse ZIP 62613
Phone
2177417832
Primary Specialty
Student (Health Education/Training)
390200000X
Additional Specialty
Athletic Trainer
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.