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General NPI Number Information
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NPI Number | 1427433838
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Entity Type | Individual
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Provider Name | MRS. ASHLEY EDER
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Gender | Female
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 816 PORTER AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-3813
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Country | US
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Telephone | 715-832-1644
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Fax |
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Provider Business Mailing Address
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Address Line | 1526 12TH AVE
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City | BLOOMER
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State | WI
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Zip | 54724-1358
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Country | US
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Telephone | 715-568-3373
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 4926-27
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License Number State | WI
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