Healthcare Provider Details

I. General information

NPI: 1336758929
Provider Name (Legal Business Name): ASHLEY HOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28345 BECK RD STE 103
WIXOM MI
48393-4733
US

IV. Provider business mailing address

28345 BECK RD STE 103
WIXOM MI
48393-4733
US

V. Phone/Fax

Practice location:
  • Phone: 668-766-3783
  • Fax:
Mailing address:
  • Phone: 248-561-5304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: