Individual
ASHTON DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC, CAC
Contact information
Practice address
306 GREENO RD S # A, FAIRHOPE, AL 36532-1905
(251) 421-3550
Mailing address
PO BOX 1881, FAIRHOPE, AL 36533-1881
(251) 421-3550
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1172
AL
101YP2500X
Professional Counselor
Primary
2106
AL
Other
Enumeration date
10/17/2013
Last updated
10/17/2013
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