Provider Demographics
NPI:1679332571
Name:MCLEAN, ASHLEY THERESA (DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:THERESA
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NEW PLANT CT STE 202
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4185
Mailing Address - Country:US
Mailing Address - Phone:443-440-6469
Mailing Address - Fax:443-429-8207
Practice Address - Street 1:20 NEW PLANT CT STE 202
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4185
Practice Address - Country:US
Practice Address - Phone:443-440-6469
Practice Address - Fax:443-429-8207
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD296142251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic