Provider Demographics
NPI:1821135682
Name:DEATON, ASHLEY SPRING (OT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:SPRING
Last Name:DEATON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 WALTON PL
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-8646
Mailing Address - Country:US
Mailing Address - Phone:704-633-5958
Mailing Address - Fax:877-991-7837
Practice Address - Street 1:1086 JENKINS BRANCH LN
Practice Address - Street 2:
Practice Address - City:MOUNT ULLA
Practice Address - State:NC
Practice Address - Zip Code:28125-8699
Practice Address - Country:US
Practice Address - Phone:877-991-7837
Practice Address - Fax:877-991-7837
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4139225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
147WROtherBLUE CROSS BLUE SHIELD
NC7310578Medicaid