Provider Demographics
NPI:1376395988
Name:MILTON, ASHLIE M
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:M
Last Name:MILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:LEARY
Mailing Address - State:GA
Mailing Address - Zip Code:39862-0142
Mailing Address - Country:US
Mailing Address - Phone:229-854-6637
Mailing Address - Fax:
Practice Address - Street 1:1350 SCENIC HWY N STE 266
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-7924
Practice Address - Country:US
Practice Address - Phone:404-780-6909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW009343104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker