Healthcare Provider Details

I. General information

NPI: 1073458840
Provider Name (Legal Business Name): ASHLEY CHILDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8353 UNIVERSITY BLVD
CORAOPOLIS PA
15108-4202
US

IV. Provider business mailing address

1307 FEDERAL ST STE 2
PITTSBURGH PA
15212-4769
US

V. Phone/Fax

Practice location:
  • Phone: 877-660-6777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: