Jra

NPI #1205116712 in Johnston, Iowa

Provider Information

NPI Number
1205116712
Entity Type
Organization
Organization Name
Jra
Primary Specialty
Psychologist - Clinical
Enumeration Date
Aug 29, 2011
Last Updated
Aug 29, 2011

Practice Location

Address
5415 NW 88TH ST
Address 2
SUITE 100
State
Iowa
ZIP Code
50131-2950
Phone
(626) 377-6844

Authorized Official

Name
DR. JOEL EDGAR ASHBY, PSY.D.
Title
PSYCHOLOGIST
Phone
(626) 377-6844

Specialties & Taxonomy Codes

Specialty
Psychologist - ClinicalClinical

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