Individual
MRS. ASHLEE MARIE SHUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, CLT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62738
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12409672
CAQH
AZ
01
—
62738
PHYSICAL THERAPY LICENSE NUMBER
OR
Enumeration date
07/11/2012
Last updated
11/26/2024
Update your record
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