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Individual

ASHLEY Y STALLWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1050 SW 6TH AVE STE 1100, PORTLAND, OR 97204-1153
(972) 379-9171
Mailing address
1745 JOURNEY FORTH TRL, WYLIE, TX 75098-0499
(601) 701-8054

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
04/16/2024
Last updated
04/22/2024
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