MEDICARE: EMBER PAGE MORAN

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
1	101Y00000X	Counselor	287357	KY

General Provider Information

NPI Number	:	1518723303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMBER PAGE MORAN

Provider Business Mailing Address
First Line	:	2496 SOUTHVIEW DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2248
Country	:	US
Telephone Number	:	859-608-2656
Fax Number	:

Provider Business Practice Location Address
First Line	:	348 E MAIN ST
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40507-1512
Country	:	US
Telephone Number	:	859-643-8905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2024
Last Update Date	:	02/28/2024

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Directions to “ EMBER PAGE MORAN ” Practice Location

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