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General NPI Number Information
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NPI Number | 1285187609
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Entity Type | Individual
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Provider Name | ASHLEY MARIE VANDEBERGHE MA
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Gender | Female
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 515 28 3/4 RD
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City | GRAND JUNCTION
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State | CO
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Zip | 81501
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Country | US
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Telephone | 970-241-6023
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Fax | 970-242-8330
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Provider Business Mailing Address
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Address Line | 1195 NW WALL ST
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City | BEND
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State | OR
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Zip | 97703-1965
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Country | US
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Telephone | 541-728-0062
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Fax | 541-306-6733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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