| Doctor Name: | MR. JERRY SCOTT EAMES |
| NPI Number: | 1033304019 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MAC CASAC ICAADC |
| License Number: | 32304 |
| Business Practice Address: | 501 N Ault St Moberly, MO - 652702506 |
| Business Phone Number: | 6602637552 |
| Business Fax Number: | 6602636593 |
| Mailing Address: | 501 N Ault St, MOBERLY |
| State: | MO |
| Postal Code: | 652702506 |
| Phone Number: | 6602637552 |
| Fax Number: | 6602636593 |
| NPI Enumeration Date: | 09/12/2007 |
| NPI Last Update Date: | 09/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 32304 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |