Provider Demographics
NPI:1285155895
Name:VANORDEN, ASHLEY LYNNE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNNE
Last Name:VANORDEN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 HELEN ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3922
Mailing Address - Country:US
Mailing Address - Phone:607-744-8161
Mailing Address - Fax:
Practice Address - Street 1:143 HELEN ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-3922
Practice Address - Country:US
Practice Address - Phone:607-744-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027976225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty