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Individual

JODY STEVENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6460 KROFT RD, MOUNT PERRY, OH 43760-9707
(740) 644-6958
Mailing address
6460 KROFT RD, MOUNT PERRY, OH 43760-9707
(740) 644-6958

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
RG136689
OH
376J00000X
Homemaker
RG136689
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0099693
LV1
OH
05
0099693
OH
Enumeration date
06/09/2014
Last updated
06/09/2014
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