Provider Demographics
NPI:1457964298
Name:WALKER, ASHLEY M
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:WEIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 DOANE AVE
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-2905
Mailing Address - Country:US
Mailing Address - Phone:413-885-8679
Mailing Address - Fax:
Practice Address - Street 1:111 DOANE AVE
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-2905
Practice Address - Country:US
Practice Address - Phone:413-885-8679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty