Healthcare Provider Details

I. General information

NPI: 1992146732
Provider Name (Legal Business Name): ASHLEY M DEVORE OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 COMMERCE DR STE 140
PERRYSBURG OH
43551-5272
US

IV. Provider business mailing address

29674 BRADNER RD
NORTHWOOD OH
43619-2433
US

V. Phone/Fax

Practice location:
  • Phone: 419-307-4429
  • Fax:
Mailing address:
  • Phone: 419-307-4429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 008395
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: