Provider Demographics
NPI:1528376332
Name:ROSE, ASHLEY (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MORIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:39B SHADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3974
Mailing Address - Country:US
Mailing Address - Phone:603-759-5111
Mailing Address - Fax:
Practice Address - Street 1:70 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6992
Practice Address - Country:US
Practice Address - Phone:603-623-5300
Practice Address - Fax:603-623-5335
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2026225X00000X
MA9476225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist