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Individual

ASHLEY LONGSTREET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3340 POPLAR AVE STE 120, MEMPHIS, TN 38111-4657
(901) 643-1843
(901) 284-0854
Mailing address
3340 POPLAR AVE STE 120, MEMPHIS, TN 38111-4657
(901) 643-1843
(901) 284-0854

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
190002954
TN
251S00000X
Community/Behavioral Health Agency
Primary
1000000024400
TN

Other

Enumeration date
07/17/2019
Last updated
07/11/2020
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