Provider Demographics
NPI:1730798497
Name:KILE, ASHLEY (LCAT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KILE
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 SAINT NICHOLAS AVE APT 3G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2956
Mailing Address - Country:US
Mailing Address - Phone:417-619-8822
Mailing Address - Fax:
Practice Address - Street 1:72 SAINT NICHOLAS AVE APT 3G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2956
Practice Address - Country:US
Practice Address - Phone:929-274-3053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001871221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist