Provider Demographics
NPI:1164260204
Name:DONHAM, ASHLEY (LLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DONHAM
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 E MICHIGAN AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-6400
Mailing Address - Country:US
Mailing Address - Phone:269-254-6613
Mailing Address - Fax:269-443-2166
Practice Address - Street 1:229 E MICHIGAN AVE STE 440
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-6400
Practice Address - Country:US
Practice Address - Phone:269-254-6613
Practice Address - Fax:269-443-2166
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6351004706103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist