Healthcare Provider Details

I. General information

NPI: 1275918625
Provider Name (Legal Business Name): ASHLEY FREECE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4077 JEFFERSON AVE
TEXARKANA AR
71854-1509
US

IV. Provider business mailing address

PO BOX 1326
MARSHALL TX
75671-1326
US

V. Phone/Fax

Practice location:
  • Phone: 870-330-9200
  • Fax: 870-330-9439
Mailing address:
  • Phone: 903-927-3782
  • Fax: 903-927-1764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP1712387
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: