Provider Information for 1093094591
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ASHLEIGH NICOLE PRATT LCSW, LICSW
Other Names:Former Name:ASHLEIGH POIRIERSex: Female
NPI: 1093094591
Last Updated: 2023-09-27
Certification Date: 2023-09-27
Certification Date: 2023-09-27
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1093094591 | ||||||||||||||||
| Enumeration Date | 2011-08-15 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 910 N DATE ST TRUTH OR CONSEQUENCES, NM 87901-1748 United States Phone: 508-560-4911 | Fax: | ||||||||||||||||
| Primary Practice Address | 1801 N PERSHING ST T OR C, NM 87901-1797 United States Phone: 508-560-4911 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 1493 CAMBRIDGE ST | ||||||||||||||||
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