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Individual

ASHLEY PORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMHCA

Contact information

Practice address
2039 MECKLENBURG HWY, MOORESVILLE, NC 28115-8574
(704) 765-2279
Mailing address
10315 WATOGA WAY, CORNELIUS, NC 28031-9016
(704) 765-2279

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A17026
NC

Other

Enumeration date
12/16/2021
Last updated
12/16/2021
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