Individual
MRS. JENNIFER MARIE LIKENS RICHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH THERAPIST
Contact information
Practice address
1901 WINDSOR AVE, OWENSBORO, KY 42301-4454
(270) 485-6120
Mailing address
1901 WINDSOR AVE, OWENSBORO, KY 42301-4454
(270) 485-6120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3276
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11903135
MEDICAID ICF
KY
01
—
33000035
MEDICAID SCL
KY
05
—
45118379
—
KY
Enumeration date
06/29/2007
Last updated
06/24/2021
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