Basic Information
| Provider Information | |||||||||
| NPI: | 1194190900 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PLACHER | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PLACHER | ||||||||
| OtherFirstName: | ASHLEY | ||||||||
| OtherMiddleName: | ELIZABETH | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 611 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | STANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488889702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898317520 | ||||||||
| FaxNumber: | 9898317578 | ||||||||
| Practice Location | |||||||||
| Address1: | 611 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | STANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488889702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898317520 | ||||||||
| FaxNumber: | 9898317578 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2015 | ||||||||
| LastUpdateDate: | 10/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 247200000X | MI | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
No ID Information.