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

LicenseStateTypeSpecialty
6176-26WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Other providers in Lake Geneva, WI

All providers in Lake Geneva, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.