Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1386398931 |
---|---|
Provider Name | Noah Tavor |
First Address | Hines, IL 60141-3030 |
Second Address | Hines, IL 60141-3030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2022 |
Last Update Date | 11/02/2022 |