| Wellness With Ami Llc | |
|
3331 Stanley Ave Ste A Dayton OH 45404-2022 | |
| (937) 203-0975 | |
| (855) 595-2759 |
| Full Name | Wellness With Ami Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3331 Stanley Ave Ste A, Dayton, Ohio |
| Authorized Official Name and Position | Ami Wallace-benning (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9372030975 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness With Ami Llc Po Box 549 Dayton OH 45404-0549 Ph: (937) 203-0975 | Wellness With Ami Llc 3331 Stanley Ave Ste A Dayton OH 45404-2022 Ph: (937) 203-0975 |
| NPI Number | 1891438313 |
|---|---|
| Provider Enumeration Date | 04/14/2022 |
| Last Update Date | 07/15/2022 |
| Certification Date | 07/15/2022 |
| Medicare PECOS PAC ID | 6507244357 |
|---|---|
| Medicare Enrollment ID | O20220607000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891438313 | NPI | - | NPPES |
| 0483745 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ami E Wallace-benning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790239390 PECOS PAC ID: 7315325164 Enrollment ID: I20220607000940 |
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