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NPI Code Detail

MEDICARE: ASHLEY GIPSON

MEDICARE:   ASHLEY  GIPSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor83579TX

General Provider Information

NPI Number : 1003505835
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY GIPSON
Provider Business Mailing Address
First Line : PO BOX 746079
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6079
Country : US
Telephone Number : 312-733-9730
Fax Number : 312-929-0373
Provider Business Practice Location Address
First Line : 6806 HIGHWAY 6 S # A
Second Line :
City : HOUSTON
State : TX
Zip : 77083-3302
Country : US
Telephone Number : 281-707-7361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2023
Last Update Date : 06/19/2026

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Directions to “ ASHLEY GIPSON ” Practice Location

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