Provider Demographics
NPI:1477834778
Name:SEAL, ASHLEY PEARL (OTRL)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PEARL
Last Name:SEAL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 MCCORKLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-8403
Mailing Address - Country:US
Mailing Address - Phone:980-223-9248
Mailing Address - Fax:
Practice Address - Street 1:328 WHIPPOORWILL LN
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-9765
Practice Address - Country:US
Practice Address - Phone:704-827-3788
Practice Address - Fax:704-827-3799
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7405225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist