Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1184201642 |
---|---|
Provider Name | Lauren Brooks |
First Address | Jacksonville, FL 32209-6525 |
Second Address | Jacksonville, FL 32209-6525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2021 |
Last Update Date | 29/03/2021 |