Provider Demographics
NPI:1477863983
Name:WELLS, ASHLEY D (BS)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:D
Last Name:WELLS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8615 NE 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-3277
Mailing Address - Country:US
Mailing Address - Phone:405-821-9647
Mailing Address - Fax:
Practice Address - Street 1:4801 N CLASSEN BLVD
Practice Address - Street 2:SUITE 233
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4627
Practice Address - Country:US
Practice Address - Phone:405-242-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health