Provider Demographics
NPI:1588810196
Name:JAGGI, ASHLEY NICOLE HOLLAND (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE HOLLAND
Last Name:JAGGI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 SE DILKE ST
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-2349
Mailing Address - Country:US
Mailing Address - Phone:801-660-9922
Mailing Address - Fax:
Practice Address - Street 1:610 SE DILKE ST
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-2349
Practice Address - Country:US
Practice Address - Phone:801-660-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-440421041C0700X
UT7060347-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical