Provider Demographics
NPI:1255082087
Name:PHIFER-DAVIS, ASHLEY ROCHELLE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROCHELLE
Last Name:PHIFER-DAVIS
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 1:5000 HAYSTACK HILL RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-4200
Mailing Address - Country:US
Mailing Address - Phone:336-504-8680
Mailing Address - Fax:
Practice Address - Street 1:208 LONG CREEK RD
Practice Address - Street 2:
Practice Address - City:BESSEMER CITY
Practice Address - State:NC
Practice Address - Zip Code:28016-9627
Practice Address - Country:US
Practice Address - Phone:336-504-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children