Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 22789 | MI |
NPI | 1588297386 |
---|---|
Provider Name | Katherine Decker |
First Address | Nottingham, MD 21236-4406 |
Second Address | Nottingham, MD 21236-4406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2020 |
Last Update Date | 20/02/2020 |