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General NPI Number Information
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NPI Number | 1245487974
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Entity Type | Individual
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Provider Name | ASHLEY KAHILA OT
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Gender | Female
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 705 ALLEN BLVD
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City | SIKESTON
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State | MO
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Zip | 63801-1907
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Country | US
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Telephone | 217-855-8509
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Fax |
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Provider Business Mailing Address
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Address Line | 705 ALLEN BLVD
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City | SIKESTON
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State | MO
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Zip | 63801-1907
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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 | 2008026307
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License Number State | MO
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