Provider Demographics
NPI:1629676622
Name:ADAMS, ASHLEY DAWN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DAWN
Last Name:ADAMS
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 1:168 GIAUDRONE RD
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5692
Mailing Address - Country:US
Mailing Address - Phone:918-470-8972
Mailing Address - Fax:
Practice Address - Street 1:168 GIAUDRONE RD
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5692
Practice Address - Country:US
Practice Address - Phone:918-474-8972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator