Provider Demographics
NPI:1194279760
Name:ASHWOOD, BRANDY (QMHP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:ASHWOOD
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-1413
Mailing Address - Country:US
Mailing Address - Phone:541-767-4268
Mailing Address - Fax:541-942-6810
Practice Address - Street 1:1245 BIRCH AVE
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-1413
Practice Address - Country:US
Practice Address - Phone:541-767-4268
Practice Address - Fax:419-942-6810
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health