Basic Information
| Provider Information | |||||||||
| NPI: | 1821635350 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SESSA | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | RYANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2110 E FLAMINGO RD STE 250 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891195193 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022703219 | ||||||||
| FaxNumber: | 8668332056 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 N ACADEMY BLVD STE 215 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809175332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193589603 | ||||||||
| FaxNumber: | 8668332056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2019 | ||||||||
| LastUpdateDate: | 01/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y |
No ID Information.