Individual
MARIANN MOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
201 22ND ST, ASHLAND, KY 41101
(606) 324-1141
(606) 325-8606
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
166225
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000559688 NONPAR
ANTHEM BCBS
—
01
—
11754983
CAQH
—
05
—
30610026
—
KY
Enumeration date
09/25/2006
Last updated
08/13/2018
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