Provider Demographics
NPI:1861849564
Name:TAYLOR, ASHLEA M (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19820 N 13TH AVE
Mailing Address - Street 2:UNIT 255
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4308
Mailing Address - Country:US
Mailing Address - Phone:623-451-6102
Mailing Address - Fax:
Practice Address - Street 1:19820 N 13TH AVE
Practice Address - Street 2:UNIT 255
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4308
Practice Address - Country:US
Practice Address - Phone:623-451-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-15172106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist