Provider Demographics
NPI:1386285286
Name:DOOT, ASHLEY GRACE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:GRACE
Last Name:DOOT
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 1:508 LIKESTON CT
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1722
Mailing Address - Country:US
Mailing Address - Phone:803-493-5657
Mailing Address - Fax:
Practice Address - Street 1:517 BENFIELD RD STE 102
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2529
Practice Address - Country:US
Practice Address - Phone:803-493-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD228831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical