Provider Demographics
NPI:1134943046
Name:MAYO, ASHLEE SHEPHERD (LMT)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:SHEPHERD
Last Name:MAYO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CENTRAL ST # 1F
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1665
Mailing Address - Country:US
Mailing Address - Phone:337-704-8173
Mailing Address - Fax:
Practice Address - Street 1:35 PARKWOOD DR LBBY C
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1699
Practice Address - Country:US
Practice Address - Phone:508-810-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17089225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist