Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 22408 | SC |
NPI | 1932672193 |
---|---|
Provider Name | Ms. Misty Renee Williams |
First Address | Taylors, SC 29687-3447 |
Second Address | Taylors, SC 29687-3447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2019 |
Last Update Date | 09/01/2019 |