Individual
ASHLEY SUZETTE KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1428 N BROAD ST APT 3, FAIRBORN, OH 45324-5567
(937) 986-8904
Mailing address
1428 N BROAD ST APT 3, FAIRBORN, OH 45324-5567
(937) 986-8904
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
191589
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/19/2025
Last updated
07/01/2025
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