Provider Demographics
NPI:1144941360
Name:SMITH, ASHLEY-LAUREN E (BS, MED)
Entity type:Individual
Prefix:
First Name:ASHLEY-LAUREN
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:BS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 LONG POINT RD STE 215
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3694
Mailing Address - Country:US
Mailing Address - Phone:800-419-2568
Mailing Address - Fax:832-358-3666
Practice Address - Street 1:7807 LONG POINT RD STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3694
Practice Address - Country:US
Practice Address - Phone:800-419-2568
Practice Address - Fax:832-358-3666
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89692101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX348651601Medicaid