Provider Demographics
NPI:1154034791
Name:SMITH, ASHLEIGH DAWN (BS,PRSS)
Entity type:Individual
Prefix:MISS
First Name:ASHLEIGH
Middle Name:DAWN
Last Name:SMITH
Suffix:
Gender:F
Credentials:BS,PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 WASHINGTON ST W
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-1333
Mailing Address - Country:US
Mailing Address - Phone:304-202-1699
Mailing Address - Fax:
Practice Address - Street 1:1010 JOHN NORMAN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1257
Practice Address - Country:US
Practice Address - Phone:304-915-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist