Provider Demographics
NPI:1568785574
Name:BOWLES, ASHLEY MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:BOWLES
Suffix:
Gender:F
Credentials:OTR/L
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 302
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:KY
Mailing Address - Zip Code:40026-0302
Mailing Address - Country:US
Mailing Address - Phone:502-228-4040
Mailing Address - Fax:502-290-0005
Practice Address - Street 1:2201 GOSHEN LN
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:KY
Practice Address - Zip Code:40026-9514
Practice Address - Country:US
Practice Address - Phone:502-228-4040
Practice Address - Fax:502-290-0005
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3676225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000652969OtherANTHEM
KY000000652969OtherANTHEM