Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XL0004X | Low Vision | 3840 | MA |
NPI | 1841619228 |
---|---|
Provider Name | Ms. Laurene Grenier |
First Address | Amherst, MA 01002-2666 |
Second Address | Amherst, MA 01002-2666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2014 |
Last Update Date | 14/04/2014 |