Healthcare Provider Details

I. General information

NPI: 1225772395
Provider Name (Legal Business Name): KATELYN S ASHBY OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3961 E GUADALUPE RD STE 1
GILBERT AZ
85234-3266
US

IV. Provider business mailing address

1976 N LEMON TREE LN UNIT 4
CHANDLER AZ
85224-2536
US

V. Phone/Fax

Practice location:
  • Phone: 480-699-4845
  • Fax:
Mailing address:
  • Phone: 480-286-6238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOTH-010483
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: