Individual
ASHTON CLAIRE CONSALVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9619 VINCA CIR APT K, CHARLOTTE, NC 28213-0523
(704) 437-0875
Mailing address
9619 VINCA CIR APT K, CHARLOTTE, NC 28213-0523
(704) 437-0875
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
821983402
AETNA
—
Enumeration date
12/05/2017
Last updated
12/05/2017
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