Healthcare Provider Details

I. General information

NPI: 1376120022
Provider Name (Legal Business Name): ASHLEY C WETTERS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3382 ANDERSONVILLE HWY
ANDERSONVILLE TN
37705-3816
US

IV. Provider business mailing address

255 LOOP HOLLOW RD
NEW TAZEWELL TN
37825-2203
US

V. Phone/Fax

Practice location:
  • Phone: 865-494-0986
  • Fax:
Mailing address:
  • Phone: 423-489-5396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5541
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: