Healthcare Provider Details

I. General information

NPI: 1689584062
Provider Name (Legal Business Name): ASHLEY BOEHM PSYCH ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 DAYLONG LN
CLARKSVILLE MD
21029-1626
US

IV. Provider business mailing address

2753 PIEDMONT HOLW
FINKSBURG MD
21048-1831
US

V. Phone/Fax

Practice location:
  • Phone: 410-531-8100
  • Fax:
Mailing address:
  • Phone: 443-713-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberA01214
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: