Provider Demographics
NPI:1316225915
Name:ASHTON, MARY ELLEN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELLEN
Last Name:ASHTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 CELEBRATION AVE
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4690
Mailing Address - Country:US
Mailing Address - Phone:321-559-4144
Mailing Address - Fax:
Practice Address - Street 1:605 CELEBRATION AVE
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4690
Practice Address - Country:US
Practice Address - Phone:321-559-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-30
Last Update Date:2011-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55155173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist