Ashley E. Boro, OT
Individual provider Active NPI Occupational Therapist · Lake Geneva, WI
NPI 1013421908 · NPPES record last updated Nov 30, 2017
Key facts
- NPI
- 1013421908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 6176-26 (WI)
- Practice address
- N2950 State Road 67
Lake Geneva, WI 53147-2655 - Phone
- (262) 245-4990
- Fax
- (262) 245-2248
- NPI assigned
- Nov 30, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6176-26 | WI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6176-26 | WI | Yes |
Addresses
Primary practice location
N2950 State Road 67
Lake Geneva, WI 53147-2655
Mailing address
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (262) 245-4990
Other names
- Ashley E. Ebersole
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- Kenneth B. Bortin
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- Amanda J Braden
- Mark Thomas Braden
All providers in Lake Geneva, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.