Provider Demographics
NPI:1013568591
Name:HYDE-SMITH, ASHLEY E (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:E
Last Name:HYDE-SMITH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4644
Mailing Address - Country:US
Mailing Address - Phone:650-270-3479
Mailing Address - Fax:
Practice Address - Street 1:501 W WILLIAMS ST UNIT 346
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-1998
Practice Address - Country:US
Practice Address - Phone:858-264-6453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist