Provider Demographics
NPI:1730631979
Name:FRISINA-DEYO, ASHLEY (MS, ATC, LAT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:FRISINA-DEYO
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:BROWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2505 MAIN ST
Mailing Address - Street 2:STATIONHOUSE SQ #207
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-5839
Mailing Address - Country:US
Mailing Address - Phone:203-385-4263
Mailing Address - Fax:203-381-2014
Practice Address - Street 1:2505 MAIN ST
Practice Address - Street 2:STATIONHOUSE SQ #207
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-5839
Practice Address - Country:US
Practice Address - Phone:203-385-4263
Practice Address - Fax:203-381-2014
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer