Provider Demographics
NPI:1740905843
Name:FREUND, ASHLEY (OTA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:FREUND
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 JEFFERSON ST STE 103A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-4443
Mailing Address - Country:US
Mailing Address - Phone:636-283-0211
Mailing Address - Fax:636-249-1155
Practice Address - Street 1:1190 JEFFERSON ST STE 103A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4443
Practice Address - Country:US
Practice Address - Phone:636-283-0211
Practice Address - Fax:636-249-1155
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022040177224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant