Provider Demographics
NPI:1285452847
Name:STAFFORD, ASHLEY (LMT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3072
Mailing Address - Country:US
Mailing Address - Phone:484-469-8663
Mailing Address - Fax:
Practice Address - Street 1:342 N QUEEN ST
Practice Address - Street 2:REAR
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3072
Practice Address - Country:US
Practice Address - Phone:484-469-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG008711225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist