Provider Demographics
NPI:1629107727
Name:HEARD, ASHLEY ELIZABETH (MS, ATC, CSCS)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:HEARD
Suffix:
Gender:F
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 MEDFORD RD
Mailing Address - Street 2:APT. 17
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-8317
Mailing Address - Country:US
Mailing Address - Phone:734-564-3702
Mailing Address - Fax:
Practice Address - Street 1:8001 CHALLIS RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-7446
Practice Address - Country:US
Practice Address - Phone:810-225-8677
Practice Address - Fax:810-225-9322
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer