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NPI Code Detail

MEDICARE: ASHLEY LATRICE COCHRAN LICSW

MEDICARE:   ASHLEY LATRICE COCHRAN  LICSW
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
11041C0700XClinical Social Worker3943CAL

General Provider Information

NPI Number : 1578009221
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY LATRICE COCHRAN LICSW
Provider Business Mailing Address
First Line : 10100 ELIDA RD
Second Line :
City : DELPHOS
State : OH
Zip : 45833-9056
Country : US
Telephone Number : 419-695-8010
Fax Number : 419-695-0004
Provider Business Practice Location Address
First Line : 9532 WYNLAKES PL
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-8515
Country : US
Telephone Number : 334-270-3181
Fax Number : 334-270-5805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2017
Last Update Date : 04/07/2021

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Directions to “ ASHLEY LATRICE COCHRAN LICSW” Practice Location

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