Provider Demographics
NPI:1154818532
Name:AMES, ASHLEY (MS, OTR)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:AMES
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6404
Mailing Address - Country:US
Mailing Address - Phone:412-487-7771
Mailing Address - Fax:412-487-7772
Practice Address - Street 1:2400 WILDWOOD RD
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-6404
Practice Address - Country:US
Practice Address - Phone:412-487-7771
Practice Address - Fax:412-487-7772
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015636225XP0200X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103493572-0002Medicaid
PA103493572-0001Medicaid
PAOC015636OtherSTATE LICENSE