Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1629574850 |
---|---|
Provider Name | Ms. Nikki Elizabeth Browder |
First Address | Detroit, MI 48224-2702 |
Second Address | Detroit, MI 48234-1460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2018 |
Last Update Date | 05/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
381459371 | (05) | MI |