Provider Demographics
NPI:1386189942
Name:ASHLEY, DONNA (EDS)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 WAGNER DR
Mailing Address - Street 2:
Mailing Address - City:MANILA
Mailing Address - State:AR
Mailing Address - Zip Code:72442-8171
Mailing Address - Country:US
Mailing Address - Phone:870-930-0214
Mailing Address - Fax:870-930-9336
Practice Address - Street 1:151 SOUTHWEST DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5828
Practice Address - Country:US
Practice Address - Phone:870-932-0090
Practice Address - Fax:870-930-9336
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR95-15E1101YS0200X
AZ95-15EI103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool