Provider Demographics
NPI:1811411861
Name:KURIAN, ASHLI GRACE (PHD)
Entity Type:Individual
Prefix:
First Name:ASHLI
Middle Name:GRACE
Last Name:KURIAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ASHLI
Other - Middle Name:G
Other - Last Name:ROLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7301 CARMEL EXECUTIVE PARK DR STE 302
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4204
Mailing Address - Country:US
Mailing Address - Phone:704-251-9084
Mailing Address - Fax:877-513-7720
Practice Address - Street 1:7301 CARMEL EXECUTIVE PARK DR STE 302
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4204
Practice Address - Country:US
Practice Address - Phone:704-251-9084
Practice Address - Fax:877-513-7720
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5891103T00000X, 103TC0700X
TX37456103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty