Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 22810 | MO |
NPI | 1528719549 |
---|---|
Provider Name | Marian Elise Cummings |
First Address | Kansas City, MO 64110-1120 |
Second Address | Kansas City, MO 64110-1120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2022 |
Last Update Date | 11/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22810 | ACVREP (01) | MO |