Provider Demographics
NPI:1336767698
Name:TOLER, ASHLEY (PLMSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TOLER
Suffix:
Gender:F
Credentials:PLMSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:D
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLMSW
Mailing Address - Street 1:711 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2733
Mailing Address - Country:US
Mailing Address - Phone:870-340-2636
Mailing Address - Fax:
Practice Address - Street 1:711 BRADLEY DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2733
Practice Address - Country:US
Practice Address - Phone:870-340-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR171M00000X
ARPLMSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator