Healthcare Provider Details

I. General information

NPI: 1609784917
Provider Name (Legal Business Name): ASHLEE ANN GEARHART OTA/L
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 S LUDLOW ST
DAYTON OH
45402-1813
US

IV. Provider business mailing address

58 W DAYTON ST
WEST ALEXANDRIA OH
45381-1128
US

V. Phone/Fax

Practice location:
  • Phone: 937-542-3000
  • Fax:
Mailing address:
  • Phone: 937-689-3493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA.001266
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: