Provider Demographics
NPI:1801620877
Name:BROWN, ASHLEY (MS, C-IAYT, 500ERYT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, C-IAYT, 500ERYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 MACON ALY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-2106
Mailing Address - Country:US
Mailing Address - Phone:937-974-4379
Mailing Address - Fax:
Practice Address - Street 1:718 MACON ALY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-2106
Practice Address - Country:US
Practice Address - Phone:937-974-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
70092317174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist