Doctor Name: | MRS. MISTY RAE ASHLEY |
NPI Number: | 1487954145 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | 31849 |
Business Practice Address: | 13001 Ramona Blvd Irwindale, CA - 917063752 |
Business Phone Number: | 6263373828 |
Business Fax Number: | 6269604163 |
Mailing Address: | 3015 E Stearns Dr, ORANGE |
State: | CA |
Postal Code: | 928695527 |
Phone Number: | 7146331914 |
Fax Number: | |
NPI Enumeration Date: | 10/28/2010 |
NPI Last Update Date: | 12/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 31849 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |