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General NPI Number Information
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NPI Number | 1588346506
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Entity Type | Individual
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Provider Name | ASHLEY LOREE ROSE LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 10266 N BAYHILL DR
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City | CEDAR HILLS
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State | UT
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Zip | 84062-8693
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Country | US
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Telephone | 385-309-1479
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Fax |
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Provider Business Mailing Address
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Address Line | 10266 N BAYHILL DR
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City | CEDAR HILLS
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State | UT
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Zip | 84062-8693
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Country | US
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Telephone | 385-309-1479
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12422236-3902
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License Number State | UT
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