Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CX0006X | Orientation and Mobility Training Provider | 6160 | FL |
Y | 225CX0006X | Orientation and Mobility Training Provider | 6160 | SC |
NPI | 1710386792 |
---|---|
Provider Name | Amanda Stolz |
First Address | Greer, SC 29651-6864 |
Second Address | Honea Path, SC 29654-9506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2014 |
Last Update Date | 05/11/2018 |