Provider Demographics
NPI:1093589103
Name:WEBB, ASHLI BRIANA
Entity Type:Individual
Prefix:
First Name:ASHLI
Middle Name:BRIANA
Last Name:WEBB
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 1:335 CLINTON RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-7803
Mailing Address - Country:US
Mailing Address - Phone:313-638-0435
Mailing Address - Fax:
Practice Address - Street 1:335 CLINTON RIVER DR
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-7803
Practice Address - Country:US
Practice Address - Phone:313-638-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704377709163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health