Provider Demographics
NPI:1881408540
Name:SMITH, ASHLEY TARA (MHA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:TARA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MHA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:TARA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5501 DELMAR BLVD STE B300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-3078
Mailing Address - Country:US
Mailing Address - Phone:314-797-3542
Mailing Address - Fax:
Practice Address - Street 1:5501 DELMAR BLVD STE B300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-3078
Practice Address - Country:US
Practice Address - Phone:314-797-3542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator