Provider Demographics
NPI:1588489801
Name:VALERIE, AHLESHA ASHON (CIT)
Entity type:Individual
Prefix:
First Name:AHLESHA
Middle Name:ASHON
Last Name:VALERIE
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11745 HAYMARKET AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6010
Mailing Address - Country:US
Mailing Address - Phone:225-888-3038
Mailing Address - Fax:225-412-7915
Practice Address - Street 1:11745 HAYMARKET AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-6010
Practice Address - Country:US
Practice Address - Phone:225-888-3038
Practice Address - Fax:225-412-7915
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACIT-5522101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)