Provider Demographics
NPI:1952509432
Name:CHORD, ASHLEE RAE (COTAL)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEE
Middle Name:RAE
Last Name:CHORD
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 AVE F
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361
Mailing Address - Country:US
Mailing Address - Phone:307-575-3575
Mailing Address - Fax:
Practice Address - Street 1:106 EAST 13TH STREET
Practice Address - Street 2:
Practice Address - City:BAYARD
Practice Address - State:NE
Practice Address - Zip Code:69334
Practice Address - Country:US
Practice Address - Phone:308-586-1142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE778224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant