Provider Demographics
NPI:1427443647
Name:PRINCE, ASHLEY RENEE (MS, ATC, CES, PES)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:RENEE
Last Name:PRINCE
Suffix:
Gender:F
Credentials:MS, ATC, CES, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6243
Mailing Address - Country:US
Mailing Address - Phone:304-243-4494
Mailing Address - Fax:
Practice Address - Street 1:316 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6243
Practice Address - Country:US
Practice Address - Phone:304-243-4494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer