Provider Demographics
NPI:1437980034
Name:GASS, ASHLEIGH (CNS)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:GASS
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 CLEVELAND ST APT 1212
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-6619
Mailing Address - Country:US
Mailing Address - Phone:310-666-0065
Mailing Address - Fax:
Practice Address - Street 1:628 CLEVELAND ST APT 1212
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-6619
Practice Address - Country:US
Practice Address - Phone:310-666-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16359133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist