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General NPI Number Information
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NPI Number | 1518723303
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Entity Type | Individual
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Provider Name | EMBER PAGE MORAN
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Gender | Female
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 348 E MAIN ST
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City | LEXINGTON
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State | KY
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Zip | 40507-1512
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Country | US
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Telephone | 859-643-8905
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Fax |
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Provider Business Mailing Address
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Address Line | 2496 SOUTHVIEW DR
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City | LEXINGTON
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State | KY
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Zip | 40503-2248
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Country | US
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Telephone | 859-608-2656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 287357
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License Number State | KY
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