Healthcare Provider Details

I. General information

NPI: 1013368893
Provider Name (Legal Business Name): ASHLEY JUSTINE HUFFMAN DBH, CCTP, LAMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 ENTERPRISE BLVD APT 5109
CHARLESTON SC
29492-8548
US

IV. Provider business mailing address

650 ENTERPRISE BLVD APT 5109
CHARLESTON SC
29492-8548
US

V. Phone/Fax

Practice location:
  • Phone: 480-349-0731
  • Fax:
Mailing address:
  • Phone: 480-349-0731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: