Provider Demographics
NPI:1841626371
Name:HERMES, ASHLEY FAY (OT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:FAY
Last Name:HERMES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 E GONZALES ST
Mailing Address - Street 2:
Mailing Address - City:YOAKUM
Mailing Address - State:TX
Mailing Address - Zip Code:77995-4515
Mailing Address - Country:US
Mailing Address - Phone:361-293-0700
Mailing Address - Fax:
Practice Address - Street 1:4208 RETAMA CIR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-2765
Practice Address - Country:US
Practice Address - Phone:361-582-0611
Practice Address - Fax:361-582-0555
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115298225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist