Provider Demographics
NPI:1487403671
Name:CLAY, ASHLEY DANIELLE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DANIELLE
Last Name:CLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:DANIELLE
Other - Last Name:CHENNAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1375 HIGHWAY 92 N
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-3379
Mailing Address - Country:US
Mailing Address - Phone:678-925-2519
Mailing Address - Fax:
Practice Address - Street 1:1015 TYRONE RD
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-2407
Practice Address - Country:US
Practice Address - Phone:770-468-3326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-18
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor