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General NPI Number Information
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NPI Number | 1891047676
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Entity Type | Individual
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Provider Name | KERRY JEAN ASHE OTR
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 7517 W COLDSPRING RD
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City | GREENFIELD
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State | WI
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Zip | 53220-2814
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Country | US
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Telephone | 414-327-6603
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Fax |
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Provider Business Mailing Address
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Address Line | 104 EDNA ST
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City | PLYMOUTH
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State | WI
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Zip | 53073-1210
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Country | US
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Telephone | 920-892-2442
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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 | 3302-26
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License Number State | WI
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