Provider Demographics
NPI:1306394036
Name:SARVIS, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SARVIS
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 1:53 SALT MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:WEST DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02670-2701
Mailing Address - Country:US
Mailing Address - Phone:845-863-9355
Mailing Address - Fax:
Practice Address - Street 1:53 SALT MEADOWS RD
Practice Address - Street 2:
Practice Address - City:WEST DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02670-2701
Practice Address - Country:US
Practice Address - Phone:845-863-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor