Healthcare Provider Details
I. General information
NPI: 1992522817
Provider Name (Legal Business Name): ERICA LYNNE ASBURY B.A., M.S., M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PO BOX 283
ROMNEY WV
26757-0283
US
IV. Provider business mailing address
PO BOX 283
ROMNEY WV
26757-0283
US
V. Phone/Fax
- Phone: 304-813-1455
- Fax:
- Phone: 304-813-1455
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | 2370-2586 |
| License Number State | WV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: