Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1639221062 |
---|---|
Provider Name | Mrs. Kandace Marie Mccue |
First Address | Willowbrook, IL 60527-3119 |
Second Address | Hines, IL 60141-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |