Provider Demographics
NPI:1659664449
Name:DEMERLE, ASHLEY RYAN (HIS)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:RYAN
Last Name:DEMERLE
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 PRINCESS ANNE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3254
Mailing Address - Country:US
Mailing Address - Phone:540-371-2333
Mailing Address - Fax:540-371-8226
Practice Address - Street 1:2601 PRINCESS ANNE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3254
Practice Address - Country:US
Practice Address - Phone:540-371-2333
Practice Address - Fax:540-371-8226
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2102002492237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist