Provider Demographics
NPI:1497427108
Name:CONNER, ASHLEY KIERSTEN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KIERSTEN
Last Name:CONNER
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 1:3700 OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1867
Mailing Address - Country:US
Mailing Address - Phone:404-644-9932
Mailing Address - Fax:
Practice Address - Street 1:4411 SUWANEE DAM RD STE 720
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8708
Practice Address - Country:US
Practice Address - Phone:678-993-8494
Practice Address - Fax:678-804-1834
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor