Provider Demographics
NPI:1114676939
Name:REICHENBACH, ASHLEY DIANE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:DIANE
Last Name:REICHENBACH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:OH
Mailing Address - Zip Code:44672-1543
Mailing Address - Country:US
Mailing Address - Phone:330-581-2271
Mailing Address - Fax:
Practice Address - Street 1:2648 EASTON ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2655
Practice Address - Country:US
Practice Address - Phone:330-956-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty