Provider Demographics
NPI:1801638010
Name:SPELL, ASHLEY MCKINLEY (RBT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MCKINLEY
Last Name:SPELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30204-4406
Mailing Address - Country:US
Mailing Address - Phone:478-696-6059
Mailing Address - Fax:
Practice Address - Street 1:502 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30204-4406
Practice Address - Country:US
Practice Address - Phone:478-696-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-24-3512752255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer