Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 5720 |
NPI | 1912547795 |
---|---|
Provider Name | Mary Katrina Berry |
First Address | Nortonville, KY 42442-9771 |
Second Address | Nortonville, KY 42442-9771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2020 |
Last Update Date | 09/01/2020 |