Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner | ||
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1811556210 |
---|---|
Provider Name | Mr. Kevin James Hollinger |
First Address | Saint Charles, MO 63304-3406 |
Second Address | Saint Charles, MO 63304-3406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 10/06/2019 |