Healthcare Provider Details

I. General information

NPI: 1508351883
Provider Name (Legal Business Name): ASHLEY MARIE HARRISON-PAVLIK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 POE AVE STE 400
DAYTON OH
45414-2527
US

IV. Provider business mailing address

6500 POE AVE STE 400
DAYTON OH
45414-2527
US

V. Phone/Fax

Practice location:
  • Phone: 937-276-3356
  • Fax:
Mailing address:
  • Phone: 937-276-3356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.08994
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: