Healthcare Provider Details

I. General information

NPI: 1386074581
Provider Name (Legal Business Name): BOBBI J ASHLEY LMHC, MHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 10/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 CULLENS RD
YELM WA
98597
US

IV. Provider business mailing address

15715 VAIL RD SE
YELM WA
98597-8467
US

V. Phone/Fax

Practice location:
  • Phone: 360-400-4860
  • Fax:
Mailing address:
  • Phone: 440-228-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1200418
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: