Provider Demographics
NPI:1033764253
Name:ASH, KATELYNN M (MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:KATELYNN
Middle Name:M
Last Name:ASH
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LAPEL
Mailing Address - State:IN
Mailing Address - Zip Code:46051-9635
Mailing Address - Country:US
Mailing Address - Phone:765-621-5637
Mailing Address - Fax:
Practice Address - Street 1:405 E 9TH ST
Practice Address - Street 2:
Practice Address - City:LAPEL
Practice Address - State:IN
Practice Address - Zip Code:46051-9635
Practice Address - Country:US
Practice Address - Phone:765-621-5637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002014A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer