Provider Demographics
NPI:1386309482
Name:ALLENSWORTH, ASHLEY KAY (CM 1)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KAY
Last Name:ALLENSWORTH
Suffix:
Gender:F
Credentials:CM 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 PARKLAWN DR STE 303
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4230
Mailing Address - Country:US
Mailing Address - Phone:405-610-3644
Mailing Address - Fax:
Practice Address - Street 1:2801 PARKLAWN DR STE 303
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4230
Practice Address - Country:US
Practice Address - Phone:405-610-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator