Provider Demographics
NPI:1851859672
Name:FEATHERSTON, ASHLEY RENEE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:FEATHERSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:RENEE
Other - Last Name:KEITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:799 SWAN RD
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-7497
Mailing Address - Country:US
Mailing Address - Phone:918-470-0060
Mailing Address - Fax:
Practice Address - Street 1:727 E WYANDOTTE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5427
Practice Address - Country:US
Practice Address - Phone:918-420-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst