Healthcare Provider Details

I. General information

NPI: 1508874124
Provider Name (Legal Business Name): RONALD ASHLEY LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 WHITESPORT DR SW STE 1
HUNTSVILLE AL
35801-7426
US

IV. Provider business mailing address

165 WHITESPORT DR SW STE 1
HUNTSVILLE AL
35801-7426
US

V. Phone/Fax

Practice location:
  • Phone: 256-883-7031
  • Fax: 256-883-7032
Mailing address:
  • Phone: 256-883-7031
  • Fax: 256-883-7032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT 277
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: