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General NPI Number Information
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NPI Number | 1417723909
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Entity Type | Organization
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Legal Business Name | PEAKSIDE PIONEERS
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 5135 W AMITY RD
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City | SALADO
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State | TX
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Zip | 76571-5214
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Country | US
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Telephone | 720-415-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 5135 W AMITY RD
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City | SALADO
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State | TX
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Zip | 76571-5214
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Country | US
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Telephone | 720-415-3440
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Fax |
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Authorized Official
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Title or Position | FOUNDER, PRESIDENT
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Name | ASHLEY HOTTMAN
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Credential | OTD, OTR/L
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Telephone | 512-677-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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