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General NPI Number Information
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NPI Number | 1568736916
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE HERNDON-DUBRA
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Gender | Female
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 38951 SCRAVEL HILL RD NE
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City | ALBANY
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State | OR
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Zip | 97322-9554
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Country | US
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Telephone | 541-974-1123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3411
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City | SALEM
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State | OR
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Zip | 97302-0411
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Country | US
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Telephone | 541-829-0592
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Fax |
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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 | R12402
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 154745
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License Number State | OR
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