Healthcare Provider Details

I. General information

NPI: 1982254637
Provider Name (Legal Business Name): ASHLEY GILMORE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2019
Last Update Date: 09/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 MACARTHUR BLVD NW
WASHINGTON DC
20016-2541
US

IV. Provider business mailing address

1501 KEARNY ST NE
WASHINGTON DC
20017-2959
US

V. Phone/Fax

Practice location:
  • Phone: 202-349-3400
  • Fax:
Mailing address:
  • Phone: 202-904-4365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010001658
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: