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General NPI Number Information
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NPI Number | 1396263372
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Entity Type | Individual
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Provider Name | ASHLEY PENCILLE
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Gender | Female
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 08/30/2017
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Provider Practice Location Address
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Address Line | 1350 RUIE RD
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-1865
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Country | US
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Telephone | 716-807-3570
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Fax |
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Provider Business Mailing Address
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Address Line | 88 INDEPENDENCE DR
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City | LOCKPORT
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State | NY
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Zip | 14094-5206
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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 | 020595
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License Number State | NY
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