Provider Demographics
NPI:1396323754
Name:NAZAROFF, ASHLEY ANN (BS, CAADC-DP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:NAZAROFF
Suffix:
Gender:F
Credentials:BS, CAADC-DP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:MALDONADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:27530 LONG ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2419
Mailing Address - Country:US
Mailing Address - Phone:517-945-1381
Mailing Address - Fax:
Practice Address - Street 1:575 S MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1778
Practice Address - Country:US
Practice Address - Phone:734-451-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)