Provider Demographics
NPI:1649519505
Name:EIKELBOOM, ASHLEE K (MS)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:K
Last Name:EIKELBOOM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:K
Other - Last Name:SADOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:213 HIGGINS HILL RD
Mailing Address - Street 2:
Mailing Address - City:MORRILL
Mailing Address - State:ME
Mailing Address - Zip Code:04952-5113
Mailing Address - Country:US
Mailing Address - Phone:207-766-1524
Mailing Address - Fax:
Practice Address - Street 1:219 MEADOW ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-5329
Practice Address - Country:US
Practice Address - Phone:207-323-2658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXM3948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist