Healthcare Provider Details

I. General information

NPI: 1184518706
Provider Name (Legal Business Name): ASHLEY HUTTON LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 HARKRIDER ST
CONWAY AR
72032-5631
US

IV. Provider business mailing address

PO BOX 414
GREENBRIER AR
72058-0414
US

V. Phone/Fax

Practice location:
  • Phone: 501-679-0232
  • Fax:
Mailing address:
  • Phone: 501-679-0232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: