Provider Demographics
NPI:1700017415
Name:MAULDIN, ASHLEY MAE (LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MAE
Last Name:MAULDIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CARDINAL LN
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-2702
Mailing Address - Country:US
Mailing Address - Phone:970-388-1903
Mailing Address - Fax:
Practice Address - Street 1:34 CARDINAL LN
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-2702
Practice Address - Country:US
Practice Address - Phone:970-388-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health