Individual
MRS. KATHI IULA ASHLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17079 PRIVATE ROAD 2251, CLYDE, TX 79510-7643
(325) 529-3192
(325) 529-3192
Mailing address
17079 PRIVATE ROAD 2251, CLYDE, TX 79510-7643
(325) 529-3192
(325) 529-3192
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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