Provider Demographics
NPI:1376120022
Name:JONES, ASHLEY C (OT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C
Last Name:JONES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 LOOP HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:NEW TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37825-2203
Mailing Address - Country:US
Mailing Address - Phone:423-489-5396
Mailing Address - Fax:
Practice Address - Street 1:3382 ANDERSONVILLE HWY
Practice Address - Street 2:
Practice Address - City:ANDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37705-3816
Practice Address - Country:US
Practice Address - Phone:865-494-0986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5541225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5541OtherTENNESSEE BOARD OF OCCUPATIONAL THERAPY
377262OtherNATIONAL BOARD CERTIFICATION OF OCCUPATIONAL THERAPY