Provider Demographics
NPI:1295133635
Name:PIMENTEL-EYE, JODY HOWLAND
Entity type:Individual
Prefix:DR
First Name:JODY
Middle Name:HOWLAND
Last Name:PIMENTEL-EYE
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 1:3001 W HIGHWAY 146
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40032-0001
Mailing Address - Country:US
Mailing Address - Phone:502-222-9441
Mailing Address - Fax:
Practice Address - Street 1:3001 W HIGHWAY 146
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40032-0001
Practice Address - Country:US
Practice Address - Phone:502-222-9441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1754103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist