Healthcare Provider Details

I. General information

NPI: 1164632204
Provider Name (Legal Business Name): ASHLEY ANNE DOWELL LPC, MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ANNE DIXON MA

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 11/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 W EMERALD ST STE 150
BOISE ID
83704-4841
US

IV. Provider business mailing address

8601 W EMERALD ST STE 150
BOISE ID
83704-4841
US

V. Phone/Fax

Practice location:
  • Phone: 208-321-0634
  • Fax:
Mailing address:
  • Phone: 208-321-0634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-3949
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: