Individual
DEANDREA MICHELLE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
JST
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
DDOUGL73
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDOUGL73
UNT WISE VOCATIONAL SERVICES
TX
Enumeration date
11/09/2020
Last updated
11/09/2020
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