Provider Demographics
NPI:1841504297
Name:BARAJAS, ASHLEY CYNTHIA (MS, APC)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:CYNTHIA
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:MS, APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 S REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84104-5112
Mailing Address - Country:US
Mailing Address - Phone:801-355-2846
Mailing Address - Fax:801-359-3244
Practice Address - Street 1:1875 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-5112
Practice Address - Country:US
Practice Address - Phone:801-355-2846
Practice Address - Fax:801-359-3244
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7685879-6009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT168302093OtherDRIVER LICENSE