Provider Demographics
NPI:1881931129
Name:KINSAUL, ASHLEY (COTA/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KINSAUL
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 1:292 COUNTY ROAD 431
Mailing Address - Street 2:
Mailing Address - City:ELBA
Mailing Address - State:AL
Mailing Address - Zip Code:36323-6526
Mailing Address - Country:US
Mailing Address - Phone:334-897-8265
Mailing Address - Fax:
Practice Address - Street 1:303 N. HURSTBOURNE PARKWAY SUITE 200
Practice Address - Street 2:PARAGON REHAB
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222
Practice Address - Country:US
Practice Address - Phone:502-412-5847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2824224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant