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NPI Code Detail

MEDICARE: DONALD DILLOW CMS, QMHS

MEDICARE: DONALD DILLOW CMS, QMHS
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
1101YM0800XMental Health CounselorQMHS
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1639780547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD DILLOW CMS, QMHS
Provider Business Mailing Address
First Line : 411 COURT ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-3932
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9620 CAREYS RUN POND CREEK RD
Second Line :
City : MC DERMOTT
State : OH
Zip : 45652-3902
Country : US
Telephone Number : 740-858-6683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2020
Last Update Date : 10/01/2024

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