Provider Demographics
NPI:1891309274
Name:KENNEDY, ASHLYN DIXON (OTR/L)
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:DIXON
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9840 ROSEMONT AVE APT 11-102
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3163
Mailing Address - Country:US
Mailing Address - Phone:901-849-4263
Mailing Address - Fax:
Practice Address - Street 1:6535 S DAYTON ST STE 1050
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-6134
Practice Address - Country:US
Practice Address - Phone:720-439-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006436225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics