Provider Demographics
NPI:1760361521
Name:THOMPSON, ASHLEY BRIANA (COTA/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BRIANA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7169 E PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-9403
Mailing Address - Country:US
Mailing Address - Phone:608-286-1171
Mailing Address - Fax:833-699-2154
Practice Address - Street 1:1738 EAGAN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3736
Practice Address - Country:US
Practice Address - Phone:608-286-1171
Practice Address - Fax:833-699-2154
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7265-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant