Provider Demographics
NPI:1962885046
Name:ASH, DIANA KATHLEEN
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:KATHLEEN
Last Name:ASH
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 1:209 W HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4311
Mailing Address - Country:US
Mailing Address - Phone:360-752-2577
Mailing Address - Fax:360-756-5843
Practice Address - Street 1:209 W HOLLY ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4311
Practice Address - Country:US
Practice Address - Phone:360-752-2577
Practice Address - Fax:360-756-5843
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG6074500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health