Provider Information for 1912088469
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Mr. BERNARD ASHLOCK LCPC, LIMHP, LPC
Sex: Male
NPI: 1912088469
Last Updated: 2024-01-10
Certification Date: 2024-01-10
Certification Date: 2024-01-10
Details
Name | Value | ||||||||||||||||
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NPI | 1912088469 | ||||||||||||||||
Enumeration Date | 2006-10-18 | ||||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||||
Sole Proprietor | YES | ||||||||||||||||
Status | Active | ||||||||||||||||
Mailing Address | 5835 SW 28TH TER TOPEKA, KS 66614-2423 United States Phone: 202-727-6826 | Fax: | ||||||||||||||||
Primary Practice Address | 805 NEW HAMPSHIRE ST STE C LAWRENCE, KS 66044-2774 United States Phone: 785-214-4012 | Fax:785-212-4015 | ||||||||||||||||
Secondary Practice Address(es) | 5835 SW 28TH TER | ||||||||||||||||
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