Provider Demographics
NPI:1487374831
Name:HERMS, AVA
Entity type:Individual
Prefix:
First Name:AVA
Middle Name:
Last Name:HERMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 PUTNAM ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-1203
Mailing Address - Country:US
Mailing Address - Phone:859-835-2729
Mailing Address - Fax:
Practice Address - Street 1:737 PUTNAM ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41071-1203
Practice Address - Country:US
Practice Address - Phone:859-835-2729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician