Provider Demographics
NPI:1700274362
Name:BREWER, ASHLEY (COTA/L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BREWER
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 1:3695 HAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:OH
Mailing Address - Zip Code:43821-9791
Mailing Address - Country:US
Mailing Address - Phone:740-586-4242
Mailing Address - Fax:
Practice Address - Street 1:3695 HAYFIELD RD
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:OH
Practice Address - Zip Code:43821
Practice Address - Country:US
Practice Address - Phone:740-586-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002712A224Z00000X
OHOTA005807224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant