Provider Demographics
NPI:1508230830
Name:BLAIR, ASHLEIGH NICOLE (MHS)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEIGH
Middle Name:NICOLE
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 OLD HWY 165
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-0072
Mailing Address - Country:US
Mailing Address - Phone:318-649-6399
Mailing Address - Fax:318-649-2356
Practice Address - Street 1:6907 OLD HWY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-0072
Practice Address - Country:US
Practice Address - Phone:318-649-6399
Practice Address - Fax:318-649-2356
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health