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General NPI Number Information
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NPI Number | 1619869328
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Entity Type | Individual
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Provider Name | MIKAELA MARIE ASCHBRENNER
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Gender | Female
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 550 BRANDON AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-3312
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Country | US
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Telephone | 207-798-0673
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SANDY RIDGE RD
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City | BRUNSWICK
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State | ME
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Zip | 04011-3902
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Country | US
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Telephone | 207-798-0673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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