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Kenneth Paul Bodine JR.
Peer Specialist in Ashtabula, Ohio
NPI 1417682790

Kenneth Paul Bodine JR. is a Peer Specialist based in Ashtabula, OH. Kenneth Paul Bodine JR. practices in Ashtabula, OH. The NPI Number for Kenneth Paul Bodine JR. is 1417682790 and holds a License No. (Ohio).

The current practice location address for Kenneth Paul Bodine JR. is 2801 C Ct, Ashtabula, OH and can be reached out via phone at 440-998-0722.

Location: 2801 C Ct, Ashtabula, OH, 44004-4577
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417682790
Provider Name
Kenneth Paul Bodine JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
2801 C Ct, Ashtabula, OH, 44004-4577
Phone Number
440-998-0722
Fax Number
Provider Enumeration Date
07/20/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2801 C Ct
City
Ashtabula
State
Ohio
Zip
44004-4577
Phone Number
440-998-0722
Fax Number
person
Provider Business Mailing Address Details
Address
2801 C Ct
City
Ashtabula
State
Ohio
Zip
44004-4577
Phone Number
440-998-0722
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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