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1114005840
RENIVA JO S. AVERY
CANMER, KY
NPI
1114005840
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
(Licence: KY F254TZ)
Enumeration Date
2006-11-01
Last Update Date
2014-03-28
Business Address
Mrs. RENIVA JO S. AVERY M.A. El.Ed.
3770 DEFRIES RD
CANMER, KY 42722
Phone number: 270-528-4416
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Mailing Address
Mrs. RENIVA JO S. AVERY M.A. El.Ed.
3770 DEFRIES RD
CANMER, KY 42722-9461
Phone number: 270-528-4416
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