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NPI Code Detail

MEDICARE: DWIGHT M. TRABUE LMFT

MEDICARE: DWIGHT M. TRABUE LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist0186KY

General Provider Information

NPI Number : 1659593176
Entity Type Code : Individual
Provider Name (Legal Business Name) : DWIGHT M. TRABUE LMFT
Provider Business Mailing Address
First Line : 9940 ALVATON RD
Second Line :
City : ALVATON
State : KY
Zip : 42122-9657
Country : US
Telephone Number : 270-746-6600
Fax Number : 270-842-9008
Provider Business Practice Location Address
First Line : 9940 ALVATON RD
Second Line :
City : ALVATON
State : KY
Zip : 42122-9657
Country : US
Telephone Number : 270-746-6600
Fax Number : 270-842-9008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 01/10/2014

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