Provider Demographics
NPI:1285474999
Name:SHOCKLEY, ASHLEY LOUISE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LOUISE
Last Name:SHOCKLEY
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17919 RANKIN AVE
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:TN
Mailing Address - Zip Code:37327-7144
Mailing Address - Country:US
Mailing Address - Phone:423-949-7899
Mailing Address - Fax:
Practice Address - Street 1:17919 RANKIN AVE
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-7144
Practice Address - Country:US
Practice Address - Phone:423-949-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7825225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist