Provider Demographics
NPI:1740603059
Name:HALL, ASHLEY M (LSW)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:M
Last Name:HALL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4052 PRIMROSE PL APT 35
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2384
Mailing Address - Country:US
Mailing Address - Phone:937-618-2694
Mailing Address - Fax:
Practice Address - Street 1:4052 PRIMROSE PL APT 35
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2384
Practice Address - Country:US
Practice Address - Phone:937-618-2694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS100022104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker