Provider Demographics
NPI:1518548130
Name:DE LOS RIOS ALDEANO, ASHLYE HEAVEN
Entity Type:Individual
Prefix:
First Name:ASHLYE
Middle Name:HEAVEN
Last Name:DE LOS RIOS ALDEANO
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 1:815 FORWARD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711
Mailing Address - Country:US
Mailing Address - Phone:608-268-6530
Mailing Address - Fax:608-709-1744
Practice Address - Street 1:815 FORWARD DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:608-268-6530
Practice Address - Fax:608-709-1744
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator