Tina Badgett

Individual provider Active NPI Developmental Therapist · Grayson, KY

NPI 1124287115 · NPPES record last updated Oct 8, 2010

Key facts

NPI
1124287115
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
149 Blue Bird LN
Grayson, KY 41143-8726
Phone
(606) 475-1912
NPI assigned
Jun 4, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X KY Yes

Addresses

Primary practice location

149 Blue Bird LN
Grayson, KY 41143-8726

Mailing address

149 Blue Bird LN
Grayson, KY 41143-8726
Phone (606) 475-1912

Other providers in Grayson, KY

All providers in Grayson, KY · Developmental Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.