Healthcare Provider Details

I. General information

NPI: 1477789154
Provider Name (Legal Business Name): ASHLEY ROSE ALLEN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 04/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 ATWELLS AVE
PROVIDENCE RI
02909-7403
US

IV. Provider business mailing address

623 ATWELLS AVE
PROVIDENCE RI
02909-7403
US

V. Phone/Fax

Practice location:
  • Phone: 401-861-2680
  • Fax: 401-751-6641
Mailing address:
  • Phone: 401-861-2680
  • Fax: 401-751-6641

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: