Provider Demographics
NPI:1194606426
Name:ASH, DESIRAE MARIE
Entity type:Individual
Prefix:
First Name:DESIRAE
Middle Name:MARIE
Last Name:ASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DESI
Other - Middle Name:
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8328 SILBERHORN HWY
Mailing Address - Street 2:
Mailing Address - City:RIGA
Mailing Address - State:MI
Mailing Address - Zip Code:49276-9776
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8328 SILBERHORN HWY
Practice Address - Street 2:
Practice Address - City:RIGA
Practice Address - State:MI
Practice Address - Zip Code:49276-9776
Practice Address - Country:US
Practice Address - Phone:419-819-8897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-11
Last Update Date:2025-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator