Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 5657 | SC |
NPI | 1376882902 |
---|---|
Provider Name | Ms. Carolyn A Cain |
First Address | West Columbia, SC 29169-7145 |
Second Address | West Columbia, SC 29169-7145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2013 |
Last Update Date | 17/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5657 | ACVREP (01) | SC |