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General NPI Number Information
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NPI Number | 1942085295
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Entity Type | Individual
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Provider Name | ASHLEIGH NICOLE CUNDIFF TCADC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 800 E MAIN ST
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City | LEXINGTON
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State | KY
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Zip | 40502-1604
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Country | US
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Telephone | 270-849-6188
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Fax |
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Provider Business Mailing Address
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Address Line | 864 BEAR TRACK RD APT 1
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-8711
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Country | US
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Telephone | 270-849-6188
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 276013
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License Number State | KY
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