Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1033678958 |
---|---|
Provider Name | Monica R Buboltz |
First Address | New Ulm, MN 56073-1933 |
Second Address | New Ulm, MN 56073-1933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2019 |
Last Update Date | 19/03/2019 |