Provider Demographics
NPI:1982906707
Name:STARUCH, ASHLEY MARIE (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE
Last Name:STARUCH
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 E CARROLL STREET
Mailing Address - Street 2:
Mailing Address - City:CARROLLTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15722-0597
Mailing Address - Country:US
Mailing Address - Phone:814-344-9238
Mailing Address - Fax:814-344-8760
Practice Address - Street 1:142 EAST CARROLL STREET
Practice Address - Street 2:
Practice Address - City:CARROLLTOWN
Practice Address - State:PA
Practice Address - Zip Code:15722-0597
Practice Address - Country:US
Practice Address - Phone:814-344-9238
Practice Address - Fax:814-344-8760
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004425133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered