Provider Demographics
NPI:1831590330
Name:ASHLEY, LAUREN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ASHLEY
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:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:AR
Mailing Address - Zip Code:72562-0543
Mailing Address - Country:US
Mailing Address - Phone:501-912-2433
Mailing Address - Fax:
Practice Address - Street 1:25 SHELBY DRIVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:AR
Practice Address - Zip Code:72562
Practice Address - Country:US
Practice Address - Phone:501-912-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist