Provider Demographics
NPI:1629767108
Name:WHITE, ASHLEY (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1913 LEO ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1918
Mailing Address - Country:US
Mailing Address - Phone:937-270-9593
Mailing Address - Fax:
Practice Address - Street 1:1913 LEO ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1918
Practice Address - Country:US
Practice Address - Phone:937-270-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.022516225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist