Individual
MRS. CANDIDA LYNN LIKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
944 FIELDS DR, BOWLING GREEN, KY 42104-5341
(270) 495-1312
Mailing address
40 ELK POND CREEK RD, GREENVILLE, KY 42345-4761
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
136603
KY
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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