Provider Demographics
NPI:1336696814
Name:LANDWEHR, ASHLEY PEARL (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:PEARL
Last Name:LANDWEHR
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 EAST 10TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47202-1023
Mailing Address - Country:US
Mailing Address - Phone:812-376-9404
Mailing Address - Fax:812-378-2849
Practice Address - Street 1:2920 EAST 10TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47202-1023
Practice Address - Country:US
Practice Address - Phone:812-376-9404
Practice Address - Fax:812-378-2849
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001903A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant