Provider Demographics
NPI:1780158584
Name:LAFAVER, ASHLEY CHRISTINE
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:CHRISTINE
Last Name:LAFAVER
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 1:4801 WELDON SPRING PKWY
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-9101
Mailing Address - Country:US
Mailing Address - Phone:636-477-2111
Mailing Address - Fax:636-477-2184
Practice Address - Street 1:4801 WELDON SPRING PKWY
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-9101
Practice Address - Country:US
Practice Address - Phone:636-477-2111
Practice Address - Fax:636-477-2184
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor