Provider Demographics
NPI:1750846879
Name:ELLIOTT, ASHLEY ELVERA (DIPLAC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ELVERA
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MIDDLESEX AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1803
Mailing Address - Country:US
Mailing Address - Phone:207-449-2962
Mailing Address - Fax:
Practice Address - Street 1:14 MIDDLESEX AVE APT 2
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1803
Practice Address - Country:US
Practice Address - Phone:207-449-2962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty