MEDICARE: ASHLEY L HENDRIE

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	156F00000X	Technician/Technologist
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1699270405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY L HENDRIE

Provider Business Mailing Address
First Line	:	42850 GARFIELD RD STE 101
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5026
Country	:	US
Telephone Number	:	586-295-2750
Fax Number	:

Provider Business Practice Location Address
First Line	:	42850 GARFIELD RD
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5026
Country	:	US
Telephone Number	:	586-295-2750
Fax Number	:

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

Provider Enumeration Date	:	03/26/2018
Last Update Date	:	10/12/2023

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Directions to “ ASHLEY L HENDRIE ” Practice Location

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