Provider Demographics
NPI:1063741981
Name:BAILEY, ASHLEY ELISABETH (COTA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELISABETH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 321
Mailing Address - Street 2:7335 E. PALMER-WASILLA HWY.
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645
Mailing Address - Country:US
Mailing Address - Phone:907-746-7300
Mailing Address - Fax:907-746-7302
Practice Address - Street 1:7335 EAST PALMER WASILLA HWY.
Practice Address - Street 2:SUITE 1-A
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-0321
Practice Address - Country:US
Practice Address - Phone:907-746-7300
Practice Address - Fax:907-746-7302
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2105224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant