| Ashley Doerge | |
|
11233 State Route 13 Sparta IL 62286-3027 | |
| (618) 598-6040 | |
| (618) 615-4151 |
| Full Name | Ashley Doerge |
|---|---|
| Speciality | Counselor - Professional |
| Location | 11233 State Route 13, Sparta, Illinois |
| Authorized Official Name and Position | Ashley Doerge (OWNER/OPERATOR) |
| Authorized Official Contact | 6185986040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Doerge 11233 State Route 13 Sparta IL 62286-3027 Ph: (618) 598-6040 | Ashley Doerge 11233 State Route 13 Sparta IL 62286-3027 Ph: (618) 598-6040 |
| NPI Number | 1437868940 |
|---|---|
| Provider Enumeration Date | 11/23/2022 |
| Last Update Date | 09/06/2023 |
| Certification Date | 11/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437868940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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