Provider Demographics
NPI:1962925529
Name:LEATHERS, ASHLEY SHARPE (OTR)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHARPE
Last Name:LEATHERS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MICHELLE
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/L
Mailing Address - Street 1:84 JOHNSON ESTATE RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-9289
Mailing Address - Country:US
Mailing Address - Phone:919-359-9073
Mailing Address - Fax:919-359-9071
Practice Address - Street 1:84 JOHNSON ESTATE RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-9289
Practice Address - Country:US
Practice Address - Phone:919-359-9073
Practice Address - Fax:919-359-9071
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9130225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist