Provider Demographics
NPI:1811612989
Name:DRACKERT, ELIZABETH MARIE (RYT-500)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:DRACKERT
Suffix:
Gender:F
Credentials:RYT-500
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ASH
Other - Last Name:YOGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5911 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-1432
Mailing Address - Country:US
Mailing Address - Phone:816-853-5714
Mailing Address - Fax:
Practice Address - Street 1:5911 MAIN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-1432
Practice Address - Country:US
Practice Address - Phone:816-853-5714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
5911964200OtherNON AFFILICATED