Provider Demographics
NPI:1225223613
Name:SHARE, ASHLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:SHARE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 CEDAR GROVE RD
Mailing Address - Street 2:
Mailing Address - City:CROSS PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37049-5109
Mailing Address - Country:US
Mailing Address - Phone:615-668-5197
Mailing Address - Fax:
Practice Address - Street 1:116 LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9163
Practice Address - Country:US
Practice Address - Phone:615-668-5197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002364103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP0000002364OtherCLINICAL PSYCHOLOGIST