Provider Demographics
NPI:1629847496
Name:KOEHN, ASHLEY BELLE (OTR)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BELLE
Last Name:KOEHN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:BELLE
Other - Last Name:FOSNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 CARE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:SD
Mailing Address - Zip Code:57212-2063
Mailing Address - Country:US
Mailing Address - Phone:605-195-4920
Mailing Address - Fax:
Practice Address - Street 1:215 S MAPLE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-4316
Practice Address - Country:US
Practice Address - Phone:605-886-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist