Provider Demographics
NPI:1720274251
Name:LEWIS, ASHLI AMY (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ASHLI
Middle Name:AMY
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:ASHLI
Other - Middle Name:AMY
Other - Last Name:HUFTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:539 E CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-3310
Mailing Address - Country:US
Mailing Address - Phone:307-587-6183
Mailing Address - Fax:
Practice Address - Street 1:2525 COUGAR AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-8438
Practice Address - Country:US
Practice Address - Phone:307-527-7784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR-551225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1770688871Medicaid