Provider Demographics
NPI:1891380747
Name:HARRIS, ASHLEY M (REEGT, RPSGT, CNIM)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:F
Credentials:REEGT, RPSGT, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-4850
Mailing Address - Country:US
Mailing Address - Phone:515-508-9139
Mailing Address - Fax:
Practice Address - Street 1:24 S WEBER ST STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1928
Practice Address - Country:US
Practice Address - Phone:866-226-8576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5916246ZE0500X
4030246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG