Provider Demographics
NPI:1306341193
Name:PRAY, ASHLEE (BS, ACT)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:PRAY
Suffix:
Gender:F
Credentials:BS, ACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-1142
Mailing Address - Country:US
Mailing Address - Phone:605-347-3003
Mailing Address - Fax:
Practice Address - Street 1:1807 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-1142
Practice Address - Country:US
Practice Address - Phone:605-347-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7766101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7766OtherBAPP