Provider Demographics
NPI:1053104992
Name:HOULE, ASHLEY (CCAR)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HOULE
Suffix:
Gender:F
Credentials:CCAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 STODDARD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-2505
Mailing Address - Country:US
Mailing Address - Phone:810-858-5653
Mailing Address - Fax:810-392-3530
Practice Address - Street 1:400 STODDARD RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-2505
Practice Address - Country:US
Practice Address - Phone:810-392-2167
Practice Address - Fax:810-392-3530
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-06-17
Deactivation Date:2025-05-23
Deactivation Code:
Reactivation Date:2025-06-17
Provider Licenses
StateLicense IDTaxonomies
MI171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator