Provider Demographics
NPI:1992078083
Name:JOHNSTONE, ASHLEY ROSE (COTA)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ROSE
Last Name:JOHNSTONE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-5505
Mailing Address - Country:US
Mailing Address - Phone:717-476-9122
Mailing Address - Fax:
Practice Address - Street 1:132 S 16TH ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-5505
Practice Address - Country:US
Practice Address - Phone:717-476-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006686224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant