Healthcare Provider Details

I. General information

NPI: 1942717806
Provider Name (Legal Business Name): ASHLEY TOKUDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2018
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 HUDSON BLVD N STE 111
OAKDALE MN
55128-7098
US

IV. Provider business mailing address

7200 HUDSON BLVD N STE 111
OAKDALE MN
55128-7098
US

V. Phone/Fax

Practice location:
  • Phone: 651-233-8966
  • Fax:
Mailing address:
  • Phone: 512-338-8966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1714
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: