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General NPI Number Information
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NPI Number | 1770165680
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Entity Type | Individual
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Provider Name | ASHLEE RAY RICHARDSON RCSWI
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Gender | Female
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 86014 PAGES DAIRY RD
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City | YULEE
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State | FL
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Zip | 32097-5203
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Country | US
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Telephone | 904-588-6741
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 28149
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City | JACKSONVILLE
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State | FL
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Zip | 32226-8149
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Country | US
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Telephone | 904-588-6741
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW15504
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License Number State | FL
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