Provider Demographics
NPI:1376245803
Name:SCARBOROUGH, ASHLEY (LM)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SCARBOROUGH
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13010 RIDGELINE BLVD APT 3206
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-1796
Mailing Address - Country:US
Mailing Address - Phone:806-685-4106
Mailing Address - Fax:
Practice Address - Street 1:101 COOPERATIVE WAY STE 105
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-8209
Practice Address - Country:US
Practice Address - Phone:512-763-7569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99510176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife