Provider Demographics
NPI:1194369066
Name:GRESLICK, ASHLEY MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:GRESLICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:FRYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1310 VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6080
Mailing Address - Country:US
Mailing Address - Phone:814-944-9970
Mailing Address - Fax:814-201-2583
Practice Address - Street 1:705 12TH ST
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2419
Practice Address - Country:US
Practice Address - Phone:814-944-9970
Practice Address - Fax:814-201-2583
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional