Provider Demographics
NPI:1003380379
Name:HOLTEN, ASHLEY RAE (OTR)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RAE
Last Name:HOLTEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 S KELVIN STRA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-4142
Mailing Address - Country:US
Mailing Address - Phone:719-304-1256
Mailing Address - Fax:
Practice Address - Street 1:2002 S KELVIN STRA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-4142
Practice Address - Country:US
Practice Address - Phone:719-304-1256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-19
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-009116225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics