Provider Demographics
NPI:1124109996
Name:BLEVINS, ASHLEY M (OT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:M
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 N MADISON TER
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-1514
Mailing Address - Country:US
Mailing Address - Phone:334-832-1080
Mailing Address - Fax:334-262-1081
Practice Address - Street 1:310 N MADISON TER
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36107-1514
Practice Address - Country:US
Practice Address - Phone:334-832-1080
Practice Address - Fax:334-262-1081
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1736225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist