Provider Demographics
NPI:1417491507
Name:PARSONS, ASHLEY NICOLE (MS, OTR)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:PARSONS
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:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39130-0415
Mailing Address - Country:US
Mailing Address - Phone:601-826-2609
Mailing Address - Fax:
Practice Address - Street 1:102 LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6952
Practice Address - Country:US
Practice Address - Phone:601-521-4934
Practice Address - Fax:601-228-4616
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018193225X00000X
FLOT19915225X00000X
MSOT3855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSOT-3855OtherMISSISSIPPI STATE BOARD OF HEALTH
FLOT19915OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH
PAOC018193OtherCOMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE