Provider Information for 1639246085
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Mr. THOMAS BENJAMIN ASHLEY LCSW
Sex: Male
NPI: 1639246085
Last Updated: 2014-03-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1639246085 | ||||||||
| Enumeration Date | 2006-11-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4010 DUPONT CIRCLE SUITE 565 LOUISVILLE, KY 40207-4888 United States Phone: 502-895-1611 | Fax:502-895-1633 | ||||||||
| Primary Practice Address | 4010 DUPONT CIRCLE SUITE 565 LOUISVILLE, KY 40207-4888 United States Phone: 502-895-1611 | Fax:502-895-1633 | ||||||||
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