Provider Demographics
NPI:1083421432
Name:SHIELDS, ASHLEY J (HEALTH PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:J
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:HEALTH PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 FALON LN # 1008
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6542
Mailing Address - Country:US
Mailing Address - Phone:814-386-3295
Mailing Address - Fax:
Practice Address - Street 1:412 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MOUNT UNION
Practice Address - State:PA
Practice Address - Zip Code:17066-1586
Practice Address - Country:US
Practice Address - Phone:814-386-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach