Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1437759149 |
---|---|
Provider Name | Denise Marie Wyatt |
First Address | Silver Spring, MD 20910-3708 |
Second Address | Silver Spring, MD 20910-3708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2020 |
Last Update Date | 30/10/2020 |