Daiquiri Fallon Ams, | |
300 Foxglove Dr, Mt Sterling, KY 40353-9769 | |
(859) 498-2135 | |
(859) 498-7547 |
Full Name | Daiquiri Fallon Ams |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 300 Foxglove Dr, Mt Sterling, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427471549 | NPI | - | NPPES |
30610026 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 171234 (Kentucky) | Primary |
Entity Name | Pathways Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982615043 PECOS PAC ID: 1254239171 Enrollment ID: O20031230000043 |
Mailing Address | Practice Location Address |
---|---|
Daiquiri Fallon Ams, Po Box 790, Ashland, KY 41105-0790 Ph: (606) 329-8588 | Daiquiri Fallon Ams, 300 Foxglove Dr, Mt Sterling, KY 40353-9769 Ph: (859) 498-2135 |
Lynn Bowling, LPCA Counselor Medicare: Medicare Enrolled Practice Location: 300 Foxglove Dr, Mt Sterling, KY 40353 Phone: 859-468-2135 Fax: 859-498-7547 | |
Jennifer Kiesling, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 Foxglove Dr, Mt Sterling, KY 40353 Phone: 859-498-2135 Fax: 859-498-7547 | |
Natalie Deering, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 Foxglove Dr, Mt Sterling, KY 40353 Phone: 859-498-2135 Fax: 859-498-7547 | |
Richard Coe, PSS Counselor Medicare: Not Enrolled in Medicare Practice Location: 209 Davis Rd, Mt Sterling, KY 40353 Phone: 859-498-6574 Fax: 859-498-7325 | |
Tara Marie Bello, Counselor Medicare: Not Enrolled in Medicare Practice Location: 209 Davis Rd, Mt Sterling, KY 40353 Phone: 859-498-6574 | |
Cassandra Jones, Counselor Medicare: Not Enrolled in Medicare Practice Location: 209 Davis Rd, Mt Sterling, KY 40353 Phone: 859-498-6574 | |
Matthew Durant, Counselor Medicare: Not Enrolled in Medicare Practice Location: 209 Davis Rd, Mt Sterling, KY 40353 Phone: 866-233-1955 |