Provider Demographics
NPI:1801305842
Name:LOVE, ASHLEY ANN MARIE (LSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN MARIE
Last Name:LOVE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:LOVE
Other - Last Name:BRANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:700 COMMERCE DR STE 290
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9256
Mailing Address - Country:US
Mailing Address - Phone:651-714-3848
Mailing Address - Fax:651-344-0820
Practice Address - Street 1:8421 WAYZATA BLVD., SUITE 305
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1395
Practice Address - Country:US
Practice Address - Phone:651-714-3848
Practice Address - Fax:651-344-0820
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program