Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1639595135 |
---|---|
Provider Name | Jennifer Burch |
First Address | Harrison, MI 48625-8721 |
Second Address | Harrison, MI 48625-8721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2014 |
Last Update Date | 09/03/2014 |