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General NPI Number Information
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NPI Number | 1992510192
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Entity Type | Individual
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Provider Name | ASHLIE COGOLLO COMBS ALC
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Gender | Female
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 215 GRAND AVE SW
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City | FORT PAYNE
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State | AL
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Zip | 35967-1917
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Country | US
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Telephone | 256-254-9628
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Fax |
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Provider Business Mailing Address
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Address Line | 192 HOOD RD
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City | RAINBOW CITY
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State | AL
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Zip | 35906-8991
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Country | US
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Telephone | 251-979-0591
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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 | ALC05201
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License Number State | AL
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