Ashley Clark, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Bristol, VA

NPI 1154886646 · NPPES record last updated Feb 8, 2019

Key facts

NPI
1154886646
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
0131001917 (VA)
Practice address
846 Old Airport Rd
Bristol, VA 24201-2244
Phone
(276) 701-5368
NPI assigned
Feb 8, 2019
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)
No

State licenses

LicenseStateTypeSpecialty
0131001917VAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131001917 VA Yes

Addresses

Primary practice location

846 Old Airport Rd
Bristol, VA 24201-2244

Mailing address

846 Old Airport Rd
Bristol, VA 24201-2244

Other identifiers

IdentifierTypeStateIssuer
0131001917OtherVACOTA/L

Other providers in Bristol, VA

All providers in Bristol, VA · Occupational Therapy Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.