Provider Demographics
NPI:1104526540
Name:BEYER, ASHLEY REGAN
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:REGAN
Last Name:BEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 WOODLAWN TER
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2992
Mailing Address - Country:US
Mailing Address - Phone:814-381-8118
Mailing Address - Fax:
Practice Address - Street 1:1770 OAK HOLLOW RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1749
Practice Address - Country:US
Practice Address - Phone:704-853-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15722225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist