Provider Demographics
NPI:1831418847
Name:WIRBICKI, ASHELY (BS)
Entity type:Individual
Prefix:MS
First Name:ASHELY
Middle Name:
Last Name:WIRBICKI
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 WYOMING AVE
Mailing Address - Street 2:CHOICES PROGRAM OF WYOMING VALLEY
Mailing Address - City:KINGSTONG
Mailing Address - State:PA
Mailing Address - Zip Code:18704
Mailing Address - Country:US
Mailing Address - Phone:570-552-3700
Mailing Address - Fax:570-552-3705
Practice Address - Street 1:REAR 307 LAIRD ST.
Practice Address - Street 2:CHOICES PROGRAM OF WYOMING VALLEY
Practice Address - City:WILKES-BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-408-9320
Practice Address - Fax:570-408-9324
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)