Provider Demographics
NPI:1417426487
Name:ASHWORH, MATTHEW STEWART
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:STEWART
Last Name:ASHWORH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3386 SNOUFFER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5707
Mailing Address - Country:US
Mailing Address - Phone:614-467-9300
Mailing Address - Fax:
Practice Address - Street 1:3386 SNOUFFER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5707
Practice Address - Country:US
Practice Address - Phone:614-467-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst