Healthcare Provider Details
I. General information
NPI: 1124716121
Provider Name (Legal Business Name): ABBEY SUE ASH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/27/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2727 SAINT JOHNS RD STE D
LIMA OH
45804-4029
US
IV. Provider business mailing address
8444 N 90TH ST STE 100
SCOTTSDALE AZ
85258-4437
US
V. Phone/Fax
- Phone: 567-940-9145
- Fax:
- Phone: 602-248-8886
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: