Provider Demographics
NPI:1396020889
Name:BEVAN, ASHLEY ELIZABETH (COTA/L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:BEVAN
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 1:1602 KANSAS AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131-2130
Mailing Address - Country:US
Mailing Address - Phone:412-302-7542
Mailing Address - Fax:
Practice Address - Street 1:1602 KANSAS AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-2130
Practice Address - Country:US
Practice Address - Phone:412-302-7542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006417224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant