Provider Demographics
NPI:1841798717
Name:KNEPPER, ASHLEY RENEE (SWA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:KNEPPER
Suffix:
Gender:F
Credentials:SWA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:R
Other - Last Name:VICKERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1880 STATE ROUTE 127
Mailing Address - Street 2:
Mailing Address - City:MARIA STEIN
Mailing Address - State:OH
Mailing Address - Zip Code:45860-9753
Mailing Address - Country:US
Mailing Address - Phone:330-442-1199
Mailing Address - Fax:
Practice Address - Street 1:4761 STATE ROUTE 29
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-8216
Practice Address - Country:US
Practice Address - Phone:419-584-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1800107OtherREGISTERED SOCIAL WORK ASSISTANT
OH165903OtherCHEMICAL DEPENDENCY COUNSELOR ASSISTANT PRELIMINARY