Provider Demographics
NPI:1184800773
Name:HARRIS, ASHLEE PAIGE (LMT)
Entity type:Individual
Prefix:MISS
First Name:ASHLEE
Middle Name:PAIGE
Last Name:HARRIS
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 1:4903 HAYDEN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-8568
Mailing Address - Country:US
Mailing Address - Phone:270-771-4903
Mailing Address - Fax:
Practice Address - Street 1:344 HIGHWAY 81 NORTH
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:KY
Practice Address - Zip Code:42371
Practice Address - Country:US
Practice Address - Phone:270-273-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2076174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist