Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1285199919 |
---|---|
Provider Name | Ms. Melanie Ruth Bush |
First Address | Great Falls, MT 59405-5821 |
Second Address | Great Falls, MT 59405-5821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2019 |
Last Update Date | 06/02/2019 |