Individual
GINA ASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8704 STATE ST, EAST SAINT LOUIS, IL 62203-2048
(618) 207-3479
Mailing address
8704 STATE ST, EAST SAINT LOUIS, IL 62203-2048
(618) 207-3479
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
016271
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
27122
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A-4215-0001-A
IL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/27/2014
Last updated
08/02/2016
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