Healthcare Provider Details

I. General information

NPI: 1346095767
Provider Name (Legal Business Name): ASHLEY MCCRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 SINBAD ST
BAKER LA
70714-4149
US

IV. Provider business mailing address

409 SINBAD ST
BAKER LA
70714-4149
US

V. Phone/Fax

Practice location:
  • Phone: 225-456-4653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number010142100
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: