Individual
JODIE VENESE GAFFNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 THARPE CT, KATHLEEN, GA 31047-3007
(478) 287-8648
Mailing address
104 THARPE CT, KATHLEEN, GA 31047-3007
(478) 287-8648
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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