Individual
SAMUEL FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., CSW
Contact information
Practice address
321 E MAIN ST, MOREHEAD, KY 40351-1671
(606) 784-4161
(606) 329-8195
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 784-4161
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7269
KY
Other
Enumeration date
11/11/2015
Last updated
04/06/2016
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