Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1053859199 |
---|---|
Provider Name | Samantha Giles |
First Address | Grand Blanc, MI 48439-2525 |
Second Address | Grand Blanc, MI 48439-2525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2017 |
Last Update Date | 09/02/2017 |