Healthcare Provider Details

I. General information

NPI: 1336014711
Provider Name (Legal Business Name): ASHLYN HARRIS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 STRAITS TPKE STE 303
MIDDLEBURY CT
06762-1836
US

IV. Provider business mailing address

1625 STRAITS TPKE STE 303
MIDDLEBURY CT
06762-1836
US

V. Phone/Fax

Practice location:
  • Phone: 203-598-0600
  • Fax:
Mailing address:
  • Phone: 203-598-0400
  • Fax: 203-598-0852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6730
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: