Individual
TINA BADGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
149 BLUE BIRD LN, GRAYSON, KY 41143-8726
(606) 475-1912
Mailing address
149 BLUE BIRD LN, GRAYSON, KY 41143-8726
(606) 475-1912
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
KY
Other
Enumeration date
06/04/2008
Last updated
10/08/2010
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