Provider Demographics
NPI:1962596593
Name:CESSNA, ASHLEY LAURA (MSOTR/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAURA
Last Name:CESSNA
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LAURA
Other - Last Name:LIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR/L
Mailing Address - Street 1:920 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5937
Mailing Address - Country:US
Mailing Address - Phone:717-222-9938
Mailing Address - Fax:
Practice Address - Street 1:920 WALNUT ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5937
Practice Address - Country:US
Practice Address - Phone:717-222-9938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist