Provider Demographics
NPI:1861218646
Name:WHITE, ASHLEY ANNE
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ANNE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 E MAPLEWOOD AVE TRLR 31
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-6846
Mailing Address - Country:US
Mailing Address - Phone:208-625-8105
Mailing Address - Fax:
Practice Address - Street 1:4301 E MAPLEWOOD AVE TRLR 31
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6846
Practice Address - Country:US
Practice Address - Phone:208-625-8105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician