Provider Demographics
NPI:1215696190
Name:HAUCK, ASHLEY C
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C
Last Name:HAUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 SONG BIRD LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1611
Mailing Address - Country:US
Mailing Address - Phone:832-385-2811
Mailing Address - Fax:
Practice Address - Street 1:10401 S MASON RD UNIT A103
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-5913
Practice Address - Country:US
Practice Address - Phone:346-933-9715
Practice Address - Fax:346-707-3537
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83697101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional