Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner | ||
N | 225CA2500X | Assistive Technology Supplier |
NPI | 1881228088 |
---|---|
Provider Name | Jana Milligan |
First Address | Fairport, NY 14450-8712 |
Second Address | Fairport, NY 14450-8712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 26/02/2020 |