Healthcare Provider Details

I. General information

NPI: 1104430032
Provider Name (Legal Business Name): ASHLEY VICTORIA GERACI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY VICTORIA STEWART

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8063 WASHINGTON VILLAGE DR
DAYTON OH
45458-1847
US

IV. Provider business mailing address

8063 WASHINGTON VILLAGE DR
DAYTON OH
45458-1847
US

V. Phone/Fax

Practice location:
  • Phone: 937-294-6004
  • Fax: 937-294-9053
Mailing address:
  • Phone: 937-294-6004
  • Fax: 937-294-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP.08966
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: