Healthcare Provider Details

I. General information

NPI: 1033761572
Provider Name (Legal Business Name): ASHLEY NEVILLE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 07/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N COLUMBUS ST
LANCASTER OH
43130-3005
US

IV. Provider business mailing address

230 N COLUMBUS ST
LANCASTER OH
43130-3005
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-0835
  • Fax:
Mailing address:
  • Phone: 740-687-0835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1802975
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: