Provider Demographics
NPI:1710570882
Name:GRAYSON, ASHLEY MONIQUE
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:MONIQUE
Last Name:GRAYSON
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 1:2280 E 73RD ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-4828
Mailing Address - Country:US
Mailing Address - Phone:216-816-4225
Mailing Address - Fax:
Practice Address - Street 1:2280 E 73RD ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4828
Practice Address - Country:US
Practice Address - Phone:216-816-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127145374700000X
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374700000XNursing Service Related ProvidersTechnician