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Contact Information

RENIVA JO S AVERY, M.A. EL.ED.
3770 DEFRIES RD
CANMER, KY42722
 Phone: 270-528-4416
 Fax: 270-528-4417
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental Therapist

222Q00000X
Indicates primary specialty

NPI Profile & details for RENIVA JO S AVERY · (Female)

NPI Number 1114005840
Status Active
Credentials M.A. EL.ED.
Entity Individual
Enumeration date 11/01/2006
Last updated 03/28/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # F254TZ
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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