Healthcare Provider Details

I. General information

NPI: 1982187670
Provider Name (Legal Business Name): ASHLEY RENEE ORDWAY M.ED./ED.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4197 NW 86TH TERRACE
GAINESVILLE FL
32606
US

IV. Provider business mailing address

3676 NW 23RD DR APT 307
GAINESVILLE FL
32605-5676
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-4357
  • Fax:
Mailing address:
  • Phone: 352-361-5589
  • 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: