Provider Demographics
NPI:1851819387
Name:SALERNO, ASHLEY T (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:T
Last Name:SALERNO
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 SUSSEX ST
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518-1662
Mailing Address - Country:US
Mailing Address - Phone:570-702-4890
Mailing Address - Fax:
Practice Address - Street 1:1000 MILL ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-3069
Practice Address - Country:US
Practice Address - Phone:570-505-5919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist