Provider Demographics
NPI:1457972440
Name:KLINGER, ASHTON GEORGETTE (OTR/L)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:GEORGETTE
Last Name:KLINGER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BURDICK RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-2505
Mailing Address - Country:US
Mailing Address - Phone:860-689-4040
Mailing Address - Fax:
Practice Address - Street 1:47 BURDICK RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06057-2505
Practice Address - Country:US
Practice Address - Phone:860-689-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT436881225X00000X
NY024626-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist