Ashley Nicole Raisor, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Ekron, KY

NPI 1902235682 · NPPES record last updated Oct 21, 2021

Key facts

NPI
1902235682
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
1035 Osborne Rd
Ekron, KY 40117-7914
Phone
(270) 501-0204
NPI assigned
Nov 4, 2013
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
212411TXMDOccupational Therapy Assistant
A5652KYMDFeeding, Eating & Swallowing Occupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 212411 TX
Feeding, Eating & Swallowing Occupational Therapy Assistant 224ZF0002X A5652 KY
Occupational Therapy Assistant 224Z00000X KY Yes

Addresses

Primary practice location

1035 Osborne Rd
Ekron, KY 40117-7914

Mailing address

1035 Osborne Rd
Ekron, KY 40117-7914
Phone (270) 501-0204

Other identifiers

IdentifierTypeStateIssuer
B07594491OtherKYDRIVERS LICENSE

Other providers in Ekron, KY

All providers in Ekron, KY · Occupational Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.