Jodie Lynn Bivens

Individual provider Active NPI Developmental Therapist · Columbia, KY

NPI 1497594626 · NPPES record last updated May 20, 2024

Key facts

NPI
1497594626
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
License
201158986 (KY)
Practice address
1102 Hemlock Cir
Columbia, KY 42728-1854
Phone
(270) 805-1417
NPI assigned
May 20, 2024
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

State licenses

LicenseStateTypeSpecialty
201158986KYMDDevelopmental Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 201158986 KY Yes

Addresses

Primary practice location

1102 Hemlock Cir
Columbia, KY 42728-1854

Mailing address

1102 Hemlock Cir
Columbia, KY 42728-1854
Phone (270) 805-1417

Other names

  • Jodie Lynn Stephens Former name

Other providers in Columbia, KY

All providers in Columbia, KY · Developmental Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.