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General NPI Number Information
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NPI Number | 1366064669
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Entity Type | Organization
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Legal Business Name | ROSLYN ASHFORD WELLNESS, INC.
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 409 W OAK ST STE 401D
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City | LAUREL
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State | MS
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Zip | 39440-4169
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Country | US
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Telephone | 601-228-1144
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Fax |
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Provider Business Mailing Address
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Address Line | 54 MATTIE DR
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City | ELLISVILLE
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State | MS
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Zip | 39437-5147
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Country | US
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Telephone | 601-307-3917
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROSLYN L ASHFORD
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Credential | LPC
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Telephone | 601-307-3917
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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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