Provider Demographics
NPI:1366959280
Name:TILLINGHAST, ASHLEY M (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:M
Last Name:TILLINGHAST
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 ATWOOD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3289
Mailing Address - Country:US
Mailing Address - Phone:401-642-8080
Mailing Address - Fax:401-246-8230
Practice Address - Street 1:1526 ATWOOD AVE STE 202
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3289
Practice Address - Country:US
Practice Address - Phone:401-642-8080
Practice Address - Fax:401-246-8230
Is Sole Proprietor?:No
Enumeration Date:2017-12-30
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01689225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0614OtherNHP
RISBA70OtherBC
RIES01788Medicaid