Provider Demographics
NPI:1427769702
Name:ENGRAM, ASHLEY (CLC, BD(DONA), MSP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:ENGRAM
Suffix:
Gender:F
Credentials:CLC, BD(DONA), MSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 ARMORY DR APT 42-E
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1736 ARMORY DR APT 42-E
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5426
Practice Address - Country:US
Practice Address - Phone:336-287-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174H00000X, 174N00000X, 374J00000X
175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175M00000XOther Service ProvidersMidwife, Lay