MEDICARE: ASHLEY PROKOPIAK OTR/L, CHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	3326	NM

General Provider Information

NPI Number	:	1609269562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY PROKOPIAK OTR/L, CHT

Provider Business Mailing Address
First Line	:	7813 24TH CT SE
Second Line	:
City	:	LACEY
State	:	WA
Zip	:	98503-3305
Country	:	US
Telephone Number	:	678-877-4851
Fax Number	:

Provider Business Practice Location Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	678-877-4851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2015
Last Update Date	:	05/05/2026

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