Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 6401013006 | MI |
NPI | 1093170094 |
---|---|
Provider Name | Mrs. Milinda Kaye Cuddeback |
First Address | Cadillac, MI 49601-2344 |
Second Address | Cadillac, MI 49601-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2015 |
Last Update Date | 18/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0M27300 | (02) | MI |
11004983923 | GROUP NPI (01) | MI |