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General NPI Number Information
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NPI Number | 1861124570
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Entity Type | Individual
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Provider Name | ROBERT DOUGLAS WACHS
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Gender | Male
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 2250 LEESTOWN RD
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City | LEXINGTON
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State | KY
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Zip | 40511-1052
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Country | US
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Telephone | 859-230-7344
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Fax | 859-281-3862
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Provider Business Mailing Address
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Address Line | 1101 VETERANS DR. (116A5-VR;SD)
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City | LEXINGTON
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State | KY
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Zip | 40502
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Country | US
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Telephone | 859-230-7344
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Fax | 859-281-3862
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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