Doctor Name: | ASHLEE CHAN |
NPI Number: | 1073989331 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA, CT |
License Number: | C.1500529-TRNE |
Business Practice Address: | 15303 State Route 170 East Liverpool, OH - 439209585 |
Business Phone Number: | 3303851000 |
Business Fax Number: | 3303853588 |
Mailing Address: | 49706 Hollywood Rd, EAST LIVERPOOL |
State: | OH |
Postal Code: | 439209446 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/20/2015 |
NPI Last Update Date: | 08/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | C.1500529-TRNE |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |