Provider Demographics
NPI:1528832300
Name:BASIRI, ASHLEY (NBC-HWC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BASIRI
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1707
Mailing Address - Country:US
Mailing Address - Phone:508-446-2375
Mailing Address - Fax:
Practice Address - Street 1:19 ROBIN RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:MA
Practice Address - Zip Code:02056-1707
Practice Address - Country:US
Practice Address - Phone:508-446-2375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAA-3534137171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach