Individual
MRS. JENNIFER LYNN BALDIVIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
206 S PATTERSON ST, VALDOSTA, GA 31601-5668
(229) 245-6565
Mailing address
3938 KARALINE CIR, VALDOSTA, GA 31605-7768
(919) 221-0755
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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