Provider Demographics
NPI:1700422482
Name:SIMPSON, ASHLEY (COTA/L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12629 HIGHWAY 5
Mailing Address - Street 2:
Mailing Address - City:MARCELINE
Mailing Address - State:MO
Mailing Address - Zip Code:64658-8167
Mailing Address - Country:US
Mailing Address - Phone:660-924-1264
Mailing Address - Fax:
Practice Address - Street 1:721 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:MO
Practice Address - Zip Code:65236-1096
Practice Address - Country:US
Practice Address - Phone:660-548-3182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014014418224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant