Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003267907 |
---|---|
Provider Name | Ashley Kasperski |
First Address | Lafayette, LA 70508-3890 |
Second Address | Lafayette, LA 70508-3890 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2016 |
Last Update Date | 22/06/2016 |