Provider Demographics
NPI:1801478326
Name:ASHLEY, GWENDOLYN JOY (PHD)
Entity type:Individual
Prefix:DR
First Name:GWENDOLYN
Middle Name:JOY
Last Name:ASHLEY
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 1:7811 TAMARRON CT
Mailing Address - Street 2:
Mailing Address - City:ATASCOCITA
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1509
Mailing Address - Country:US
Mailing Address - Phone:812-989-0532
Mailing Address - Fax:
Practice Address - Street 1:7811 TAMARRON CT
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-1509
Practice Address - Country:US
Practice Address - Phone:812-989-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385H00000XRespite Care FacilityRespite Care
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, ChildGroup - Multi-Specialty