Provider Demographics
NPI:1992416564
Name:ABERNATHY, ASHLI
Entity type:Individual
Prefix:
First Name:ASHLI
Middle Name:
Last Name:ABERNATHY
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 1:1807 MAPLEWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3028
Mailing Address - Country:US
Mailing Address - Phone:214-856-0244
Mailing Address - Fax:
Practice Address - Street 1:1807 MAPLEWOOD TRL
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3028
Practice Address - Country:US
Practice Address - Phone:214-856-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional