Healthcare Provider Details

I. General information

NPI: 1841120391
Provider Name (Legal Business Name): ASHLEY GRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W LAGRANGE RD
HANOVER IN
47243-9439
US

IV. Provider business mailing address

66 FRANKLIN AVE
CAMPBELLSBURG KY
40011-1430
US

V. Phone/Fax

Practice location:
  • Phone: 812-866-2625
  • Fax:
Mailing address:
  • Phone: 502-693-2422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number32003021A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: