Individual
MRS. JODIE LYNN BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 HEMLOCK CIR, COLUMBIA, KY 42728-1854
(270) 805-1417
Mailing address
1102 HEMLOCK CIR, COLUMBIA, KY 42728-1854
(270) 805-1417
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
201158986
KY
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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