Provider Demographics
NPI:1235352352
Name:HART, ASHLEY BRUCE II (PHD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BRUCE
Last Name:HART
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:106 E 1ST ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-1472
Mailing Address - Country:US
Mailing Address - Phone:928-341-1046
Mailing Address - Fax:928-341-1048
Practice Address - Street 1:106 E 1ST ST
Practice Address - Street 2:SUITE D
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-1450
Practice Address - Country:US
Practice Address - Phone:928-341-1046
Practice Address - Fax:928-341-1048
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2012-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ1076103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic