Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | SC |
NPI | 1023357019 |
---|---|
Provider Name | Alicia M Pugh |
First Address | Spartanburg, SC 29302-4628 |
Second Address | Spartanburg, SC 29302-4628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2013 |
Last Update Date | 11/02/2013 |