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NPI Code Detail

MEDICARE: JENNIFER BASH

MEDICARE: JENNIFER BASH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker4669KY

General Provider Information

NPI Number : 1093844235
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BASH
Provider Business Mailing Address
First Line : 1382 S 3RD ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40208-2351
Country : US
Telephone Number : 502-637-4361
Fax Number : 502-637-4490
Provider Business Practice Location Address
First Line : 1382 S 3RD ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40208-2351
Country : US
Telephone Number : 502-637-4361
Fax Number : 502-637-4490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 10/09/2008

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Directions to “ JENNIFER BASH ” Practice Location

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