Provider Demographics
NPI:1679039929
Name:ATKINSON, ASHLEIGH DENICE (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEIGH
Middle Name:DENICE
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 PEBBLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32220-1322
Mailing Address - Country:US
Mailing Address - Phone:912-309-1884
Mailing Address - Fax:
Practice Address - Street 1:420 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1802
Practice Address - Country:US
Practice Address - Phone:229-333-8001
Practice Address - Fax:229-333-8333
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18444225X00000X
GAOT006202225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist