Provider Demographics
NPI:1093346041
Name:KENAR, ASHLEY CAITLIN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CAITLIN
Last Name:KENAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 WOODBURN RD UNIT H
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-7502
Mailing Address - Country:US
Mailing Address - Phone:262-309-0134
Mailing Address - Fax:
Practice Address - Street 1:2114 WOODBURN RD UNIT H
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-7502
Practice Address - Country:US
Practice Address - Phone:262-309-0134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer