Provider Demographics
NPI:1851038707
Name:KEE, ASHLEY SIMONE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SIMONE
Last Name:KEE
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 1:600 CLIFFT ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:TN
Mailing Address - Zip Code:38008-2404
Mailing Address - Country:US
Mailing Address - Phone:731-332-0623
Mailing Address - Fax:
Practice Address - Street 1:600 CLIFFT ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-2404
Practice Address - Country:US
Practice Address - Phone:731-332-0623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13556104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker