Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 5201006776 | MI |
NPI | 1710476148 |
---|---|
Provider Name | Donna Lynn Gorman |
First Address | Chesterfield, MI 48047-4378 |
Second Address | Clinton Township, MI 48038-3504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2018 |
Last Update Date | 01/05/2018 |