Provider Demographics
NPI:1992795801
Name:ASHBY, MYRNA LOY (LMFT, LPC)
Entity type:Individual
Prefix:MS
First Name:MYRNA
Middle Name:LOY
Last Name:ASHBY
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 COLLEYVILLE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034
Mailing Address - Country:US
Mailing Address - Phone:817-310-0507
Mailing Address - Fax:817-310-0877
Practice Address - Street 1:6226 COLLEYVILLE BLVD
Practice Address - Street 2:A
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6277
Practice Address - Country:US
Practice Address - Phone:817-310-0507
Practice Address - Fax:817-310-0877
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4149101YP2500X
TX34743793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional