Provider Demographics
NPI:1386132157
Name:HENSLEY, ASHLEY LYNN (PTA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 AMSTERDAM RD
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3712
Mailing Address - Country:US
Mailing Address - Phone:858-426-6400
Mailing Address - Fax:
Practice Address - Street 1:2344 AMSTERDAM RD
Practice Address - Street 2:
Practice Address - City:VILLA HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3712
Practice Address - Country:US
Practice Address - Phone:859-426-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA02902225200000X
OHPTA008729225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYA02902OtherKENTUCKY BOARD OF PHYSICAL THERAPY
OHPTA008729OtherOHIO BOARD OF PHYSICAL THERAPY