Provider Demographics
NPI:1164904488
Name:HESSELTINE, ASHLYN PEGGY
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:PEGGY
Last Name:HESSELTINE
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:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:ORANGE GROVE
Mailing Address - State:TX
Mailing Address - Zip Code:78372-0429
Mailing Address - Country:US
Mailing Address - Phone:361-816-4435
Mailing Address - Fax:
Practice Address - Street 1:551 CR 315
Practice Address - Street 2:
Practice Address - City:ORANGE GROVE
Practice Address - State:TX
Practice Address - Zip Code:78372
Practice Address - Country:US
Practice Address - Phone:361-816-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer