MEDICARE: ASHLEY GILL

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	103TC0700X	Clinical Psychologist	11450134-2501	UT

General Provider Information

NPI Number	:	1992314470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY GILL

Provider Business Mailing Address
First Line	:	627 PITTSBURGH RD STE 2
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-2200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	627 PITTSBURGH RD STE 2
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-2200
Country	:	US
Telephone Number	:	724-439-4990
Fax Number	:

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

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	07/30/2020

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Directions to “ ASHLEY GILL ” Practice Location

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