Individual
OLUWAGBOTEMI AYOMIDE ASHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ICC
Contact information
Practice address
300 BATTLES ST, BROCKTON, MA 02301-2231
(508) 587-2579
(508) 583-8046
Mailing address
11 N LEYDEN ST, BROCKTON, MA 02302-3858
(617) 480-4164
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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