Provider Demographics
NPI:1912101700
Name:CANALE, ASHLEY NICOLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:CANALE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:BOEHME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16810 GYPSY RED DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6271
Mailing Address - Country:US
Mailing Address - Phone:225-892-5425
Mailing Address - Fax:
Practice Address - Street 1:16306 SPRING CYPRESS RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7356
Practice Address - Country:US
Practice Address - Phone:225-892-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11435225100000X
TX1171399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist