MEDICARE: ASHLEY WHITLEY LMFT

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
1	106H00000X	Marriage & Family Therapist	203710	TX

General Provider Information

NPI Number	:	1740935436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY WHITLEY LMFT

Provider Business Mailing Address
First Line	:	2006 SUMMER PLACE DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-3049
Country	:	US
Telephone Number	:	225-276-7739
Fax Number	:

Provider Business Practice Location Address
First Line	:	2006 SUMMER PLACE DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-3049
Country	:	US
Telephone Number	:	225-276-7739
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2022
Last Update Date	:	02/21/2022

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Directions to “ ASHLEY WHITLEY LMFT” Practice Location

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