Provider Demographics
NPI:1245053248
Name:VELASQUEZ, ASHLEY ROSE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSE
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ELMIRA LOOP APT 5H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-2006
Mailing Address - Country:US
Mailing Address - Phone:646-402-4941
Mailing Address - Fax:
Practice Address - Street 1:2656 E 23RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2826
Practice Address - Country:US
Practice Address - Phone:646-402-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health