Healthcare Provider Details

I. General information

NPI: 1336009406
Provider Name (Legal Business Name): ASHLEY L WARE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 S CENTRAL CAMPUS DR STE 3525
SALT LAKE CITY UT
84112-9199
US

IV. Provider business mailing address

10 W BROADWAY STE 700
SALT LAKE CITY UT
84101-2060
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-4697
  • Fax:
Mailing address:
  • Phone: 385-715-0098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number14234449-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: