Provider Demographics
NPI:1548036825
Name:SCHLICHENMAYER, ASHANTI RAYME
Entity type:Individual
Prefix:
First Name:ASHANTI
Middle Name:RAYME
Last Name:SCHLICHENMAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 36TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2074
Mailing Address - Country:US
Mailing Address - Phone:612-704-5501
Mailing Address - Fax:
Practice Address - Street 1:7720 36TH AVE N APT 301
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55427-2052
Practice Address - Country:US
Practice Address - Phone:612-704-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician