Provider Demographics
NPI:1013507649
Name:MITCHELL, ASHLEE (COTA/L)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7524 NORTHWAY CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-5326
Mailing Address - Country:US
Mailing Address - Phone:580-335-1789
Mailing Address - Fax:
Practice Address - Street 1:1620 MIDTOWN PL
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6347
Practice Address - Country:US
Practice Address - Phone:405-397-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant