Individual
BEVERLEY ANNETTE CAUDILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
337 HIGHWAY 3408, BLACKEY, KY 41804-9041
(606) 205-6058
Mailing address
337 HIGHWAY 3408, BLACKEY, KY 41804-9041
(606) 205-6058
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
200112990
KY
Other
Enumeration date
01/13/2011
Last updated
06/29/2023
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