Provider Demographics
NPI:1437946472
Name:SIMONS, ASHLEY (RD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SIMONS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 SAGAMORE ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1331
Mailing Address - Country:US
Mailing Address - Phone:802-779-2358
Mailing Address - Fax:
Practice Address - Street 1:63 SAGAMORE ST UNIT 1
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-1331
Practice Address - Country:US
Practice Address - Phone:802-779-2358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86093651133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered