Provider Demographics
NPI:1013499953
Name:STONEROCK, ASHLEY SUZETTE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUZETTE
Last Name:STONEROCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:SUZETTE
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1944
Mailing Address - Country:US
Mailing Address - Phone:937-417-3093
Mailing Address - Fax:
Practice Address - Street 1:600 WALNUT ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1944
Practice Address - Country:US
Practice Address - Phone:937-417-3093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRA.161817405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional