MEDICARE: ASHLEY TOKUDA

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	101YP2500X	Professional Counselor	1714	MN

General Provider Information

NPI Number	:	1942717806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY TOKUDA

Provider Business Mailing Address
First Line	:	7200 HUDSON BLVD N STE 111
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-7098
Country	:	US
Telephone Number	:	512-338-8966
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 HUDSON BLVD N STE 111
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-7098
Country	:	US
Telephone Number	:	651-233-8966
Fax Number	:

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

Provider Enumeration Date	:	01/01/2018
Last Update Date	:	10/31/2023

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Directions to “ ASHLEY TOKUDA ” Practice Location

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