Pedigo, Lereasa Lynne

Pedigo, Lereasa Lynne is an individual health care provider with primary practice located at 822 Woodway St , Bowling Green KY 42101-2771. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Pedigo, Lereasa Lynne can be contacted via phone (270) 901-5000.

Contact Information

Primary practice address
822 Woodway St Bowling Green KY 42101-2771
Phone: (270) 901-5000
Fax: (270) 842-0721
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0272 Kentucky

Profile Details

NPI number 1396870804
LBN Legal business name Pedigo, Lereasa Lynne
Credentials CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396870804 NPPES
Kentucky MEDICAID 30604011

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