Provider Demographics
NPI:1780930222
Name:MAHONEY, ASHLEY NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 ANTIOC
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204
Mailing Address - Country:US
Mailing Address - Phone:913-652-9229
Mailing Address - Fax:913-652-9198
Practice Address - Street 1:6700 ANTIOCH
Practice Address - Street 2:SUITE 120
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-652-9229
Practice Address - Fax:913-652-9198
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist