Provider Demographics
NPI:1164797023
Name:BRANDT, ASHLEY ERIN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ERIN
Last Name:BRANDT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:ERIN
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:3509 BRASELTON HWY
Mailing Address - Street 2:BLDG F
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019
Mailing Address - Country:US
Mailing Address - Phone:715-212-4278
Mailing Address - Fax:
Practice Address - Street 1:3509 BRASELTON HWY
Practice Address - Street 2:BLDG F
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1107
Practice Address - Country:US
Practice Address - Phone:715-212-4278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0019832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer