Dominique Atencio, BA

Individual provider Active NPI Case Manager/Care Coordinator · Lexington, KY

NPI 1447614342 · NPPES record last updated Apr 7, 2016

Key facts

NPI
1447614342
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
201 Mechanic St
Lexington, KY 40507-1086
Phone
(859) 272-7483
Fax
(859) 272-9685
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

201 Mechanic St
Lexington, KY 40507-1086

Mailing address

201 Mechanic St
Lexington, KY 40507-1086
Phone (859) 272-7483

Other identifiers

IdentifierTypeStateIssuer
1790731081MedicaidKY

Other providers in Lexington, KY

All providers in Lexington, KY · Case Manager/Care Coordinator in Kentucky

Sources for this page

Verify at the official NPI Registry.