Provider Demographics
NPI:1972601953
Name:ASHLEY-CAMERON, SYLVIA ELAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:ELAINE
Last Name:ASHLEY-CAMERON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E MAIN STREET
Mailing Address - Street 2:SUITE 204 MANKATO CHILD PSYCHOLOGY CLINIC PA
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001
Mailing Address - Country:US
Mailing Address - Phone:507-345-5590
Mailing Address - Fax:507-345-3550
Practice Address - Street 1:220 E MAIN STREET
Practice Address - Street 2:SUITE 204 MANKATO CHILD PSYCHOLOGY CLINIC PA
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001
Practice Address - Country:US
Practice Address - Phone:507-345-5590
Practice Address - Fax:507-345-3550
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1391103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
42552ASOtherBLUE CROSS BLUE SHIELD