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General NPI Number Information
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NPI Number | 1104501105
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Entity Type | Individual
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Provider Name | ASHLEY LAYNE
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Gender | Female
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/18/2023
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Provider Practice Location Address
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Address Line | 1 VETERANS DR
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-2309
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Country | US
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Telephone | 612-413-7885
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Fax |
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Provider Business Mailing Address
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Address Line | 450 CLARKSON AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-2012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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