Individual
MS. JAYNA LYNN WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 GREENWOOD PL, BENTON, KY 42025-7640
(270) 703-7398
Mailing address
1286 BETHEL RD, BENTON, KY 42025-8418
(270) 703-8954
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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