Provider Demographics
NPI:1952716797
Name:STAVISH, ASHLEY (AU,D,)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:STAVISH
Suffix:
Gender:F
Credentials:AU,D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 CREAMERY WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2533
Mailing Address - Country:US
Mailing Address - Phone:610-384-8300
Mailing Address - Fax:610-363-5247
Practice Address - Street 1:10801 LOCKWOOD DR STE 360
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1563
Practice Address - Country:US
Practice Address - Phone:301-593-5200
Practice Address - Fax:301-593-7835
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006354231H00000X
MD01472237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA358938Medicare PIN