Provider Demographics
NPI:1508559402
Name:INDEPENDENT WORKERS
Entity Type:Organization
Organization Name:INDEPENDENT WORKERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VISUALLY IMPAIRED TEACHER
Authorized Official - Prefix:
Authorized Official - First Name:YAYO
Authorized Official - Middle Name:S
Authorized Official - Last Name:RADDER
Authorized Official - Suffix:
Authorized Official - Credentials:VI CERTIFICATION
Authorized Official - Phone:502-413-7962
Mailing Address - Street 1:144 ANGEL FALLS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8828
Mailing Address - Country:US
Mailing Address - Phone:502-413-7962
Mailing Address - Fax:
Practice Address - Street 1:144 ANGEL FALLS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-8828
Practice Address - Country:US
Practice Address - Phone:502-413-7962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency