Healthcare Provider Details

I. General information

NPI: 1093562233
Provider Name (Legal Business Name): ASHLEY MCCLAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 CHALLIS RD
BRIGHTON MI
48116-7446
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DR. 3116 TC, SPC 5368
ANN ARBOR MI
48109
US

V. Phone/Fax

Practice location:
  • Phone: 734-998-2020
  • Fax:
Mailing address:
  • Phone: 734-998-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351053919
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: