Individual
CASSANDR KIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2945 GARDNERSVILLE RD, CRITTENDEN, KY 41030-8244
(859) 462-4508
Mailing address
2945 GARDNERSVILLE RD, CRITTENDEN, KY 41030-8244
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
2552670
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2552670
—
OH
Enumeration date
11/16/2016
Last updated
11/16/2016
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