Wellness With Ami Llc | |
3331 Stanley Ave Ste A Dayton OH 45404-2022 | |
(937) 203-0975 | |
(855) 595-2759 |
Full Name | Wellness With Ami Llc |
---|---|
Speciality | Social Worker |
Location | 3331 Stanley Ave Ste A, Dayton, Ohio |
Authorized Official Name and Position | Ami Wallace-benning (OWNER/CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 9372030975 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Wellness With Ami Llc Po Box 549 Dayton OH 45404-0549 Ph: (937) 203-0975 | Wellness With Ami Llc 3331 Stanley Ave Ste A Dayton OH 45404-2022 Ph: (937) 203-0975 |
NPI Number | 1891438313 |
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Provider Enumeration Date | 04/14/2022 |
Last Update Date | 07/15/2022 |
Certification Date | 07/15/2022 |
Medicare PECOS PAC ID | 6507244357 |
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Medicare Enrollment ID | O20220607000879 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891438313 | NPI | - | NPPES |
0483745 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Ami E Wallace-benning |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1790239390 PECOS PAC ID: 7315325164 Enrollment ID: I20220607000940 |
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