Provider Demographics
NPI:1609517051
Name:PADDOCK, ASHLEY ELIZABETH
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:PADDOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1505
Mailing Address - Country:US
Mailing Address - Phone:330-801-0787
Mailing Address - Fax:
Practice Address - Street 1:132 S BROAD ST STE 101
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1437
Practice Address - Country:US
Practice Address - Phone:330-801-0787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical