Provider Demographics
NPI:1205582632
Name:FALLER, ASHLEY N (PTA)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:N
Last Name:FALLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 GREENHILL AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-2627
Mailing Address - Country:US
Mailing Address - Phone:843-441-2405
Mailing Address - Fax:
Practice Address - Street 1:2118 GREENSPRING DR STE 200
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3112
Practice Address - Country:US
Practice Address - Phone:410-512-5820
Practice Address - Fax:410-512-5859
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA5142225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant