Basic Information
| Provider Information | |||||||||
| NPI: | 1619336799 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASHE | ||||||||
| FirstName: | TREVOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 515 CLANTON RD | ||||||||
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| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282171309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043329010 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 COPPERFIELD BLVD NE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280252428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047823131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2016 | ||||||||
| LastUpdateDate: | 04/26/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 11032A | NC | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.