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NPI Code Detail

MEDICARE: ASHLEY BEAUDRY MA

MEDICARE: ASHLEY BEAUDRY MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor180007974IL

General Provider Information

NPI Number : 1518244656
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY BEAUDRY MA
Provider Business Mailing Address
First Line : 70 S RIVER ST
Second Line :
City : AURORA
State : IL
Zip : 60506-5185
Country : US
Telephone Number : 630-844-2662
Fax Number : 630-844-3084
Provider Business Practice Location Address
First Line : 70 S RIVER ST
Second Line :
City : AURORA
State : IL
Zip : 60506-5185
Country : US
Telephone Number : 630-844-2662
Fax Number : 630-844-3084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2011
Last Update Date : 11/03/2011

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1528307766 — KIMBERLY JOHNSON LPC
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Directions to “ ASHLEY BEAUDRY MA” Practice Location

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