Healthcare Provider Details

I. General information

NPI: 1386132769
Provider Name (Legal Business Name): ASHLEIGH SPENCER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEIGH POLLOCK

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 THOMAS JEFFERSON RD STE 3
FOREST VA
24551-2579
US

IV. Provider business mailing address

1061 BLUE RIDGE VIEW CIR
FOREST VA
24551-4379
US

V. Phone/Fax

Practice location:
  • Phone: 434-202-4080
  • Fax:
Mailing address:
  • Phone: 912-602-8765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: