Provider Demographics
NPI:1790012219
Name:GREENHAW, ASHLEIGH H (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEIGH
Middle Name:H
Last Name:GREENHAW
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W. JACKSON STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157
Mailing Address - Country:US
Mailing Address - Phone:601-853-9747
Mailing Address - Fax:601-898-4761
Practice Address - Street 1:115 W. JACKSON STREET
Practice Address - Street 2:SUITE F
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157
Practice Address - Country:US
Practice Address - Phone:601-853-9747
Practice Address - Fax:601-898-4761
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT2328225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics