Provider Demographics
NPI:1326536582
Name:KIES, ASHLEY L (PHD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:KIES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291/30 SAMMAKORN CONDOMINIUM
Mailing Address - Street 2:112 RAMKHAMHANG ROAD
Mailing Address - City:BANGKOK
Mailing Address - State:SAPHAN SUNG DISTRICT
Mailing Address - Zip Code:10240
Mailing Address - Country:TH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BROMSGROVE INTL SCHOOL 55 MU9 WINDSOR PARK GOLF CLUB
Practice Address - Street 2:SUWINTHAWONG 15 ROAD
Practice Address - City:BANGKOK
Practice Address - State:MINBURI
Practice Address - Zip Code:10510
Practice Address - Country:TH
Practice Address - Phone:064-248-0689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10399103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling