Provider Demographics
NPI:1083307987
Name:HUBBARD, ASHTON KOLE
Entity Type:Individual
Prefix:MISS
First Name:ASHTON
Middle Name:KOLE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 W BISHOP DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-3354
Mailing Address - Country:US
Mailing Address - Phone:636-295-2743
Mailing Address - Fax:
Practice Address - Street 1:401 CORPORATE PARK DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-4201
Practice Address - Country:US
Practice Address - Phone:314-725-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant