Provider Demographics
NPI:1659929230
Name:DOUTHITT, ASHLYN
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:DOUTHITT
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 1:3505 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3718
Mailing Address - Country:US
Mailing Address - Phone:317-920-5900
Mailing Address - Fax:
Practice Address - Street 1:435 E MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1454
Practice Address - Country:US
Practice Address - Phone:317-920-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002073A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist