MEDICARE: DANIEL ASH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-20-45894	OH

General Provider Information

NPI Number	:	1538825807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL ASH

Provider Business Mailing Address
First Line	:	377B LEAR RD STE 128
Second Line	:
City	:	AVON LAKE
State	:	OH
Zip	:	44012-2938
Country	:	US
Telephone Number	:	440-644-0128
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 CROCKER RD
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-6315
Country	:	US
Telephone Number	:	440-871-4150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2021
Last Update Date	:	01/29/2024

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