Provider Demographics
NPI:1790429876
Name:RISNER, ASHLEY BETH (QBHS)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:BETH
Last Name:RISNER
Suffix:
Gender:F
Credentials:QBHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3964 WHEAT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-9457
Mailing Address - Country:US
Mailing Address - Phone:937-544-2574
Mailing Address - Fax:
Practice Address - Street 1:3964 WHEAT RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-9457
Practice Address - Country:US
Practice Address - Phone:937-544-2574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator