Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 7369 |
NPI | 1972038701 |
---|---|
Provider Name | Mr. David Aaron Rouby |
First Address | Watertown, MA 02472-2638 |
Second Address | Watertown, MA 02472-2638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2017 |
Last Update Date | 30/04/2017 |