Provider Demographics
NPI:1083494009
Name:ASHLEY, ANGELA (LPN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:UZHCA PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDCA-CPRS
Mailing Address - Street 1:117 HIGHRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-1759
Mailing Address - Country:US
Mailing Address - Phone:937-718-6328
Mailing Address - Fax:
Practice Address - Street 1:117 HIGHRIDGE CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-1759
Practice Address - Country:US
Practice Address - Phone:937-718-6328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151353.MEDS-IV164W00000X
175T00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No175T00000XOther Service ProvidersPeer Specialist