Individual
ASHLYN BLAINE GAUTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2800 FORUM BLVD STE 4A, COLUMBIA, MO 65203-5468
(573) 542-0578
Mailing address
2800 FORUM BLVD STE 4A, COLUMBIA, MO 65203-5468
(573) 542-0578
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2019030961
MO
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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