Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 744722 | WI |
NPI | 1689155947 |
---|---|
Provider Name | Mrs. Rachel Joy Niziolek |
First Address | Weston, WI 54476-2064 |
Second Address | Weston, WI 54476-2064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2018 |
Last Update Date | 24/08/2018 |