Provider Demographics
NPI:1922133750
Name:ASH, DELLY (MFT)
Entity Type:Individual
Prefix:
First Name:DELLY
Middle Name:
Last Name:ASH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14400 ADDISON ST APT 216
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1703
Mailing Address - Country:US
Mailing Address - Phone:818-986-4703
Mailing Address - Fax:
Practice Address - Street 1:14400 ADDISON ST APT 216
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1703
Practice Address - Country:US
Practice Address - Phone:818-986-4703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42467106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist