Provider Demographics
NPI:1538825807
Name:ASH, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377B LEAR RD STE 128
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2938
Mailing Address - Country:US
Mailing Address - Phone:440-644-0128
Mailing Address - Fax:
Practice Address - Street 1:3600 CROCKER RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6315
Practice Address - Country:US
Practice Address - Phone:440-871-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-20-45894103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst