Provider Demographics
NPI:1023413044
Name:HOPKINS, ASHLEY (OT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:OT
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 234
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA
Mailing Address - State:IN
Mailing Address - Zip Code:47862-0234
Mailing Address - Country:US
Mailing Address - Phone:317-805-4963
Mailing Address - Fax:317-818-0720
Practice Address - Street 1:9480 PRIORITY WAY WEST DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1470
Practice Address - Country:US
Practice Address - Phone:317-805-4963
Practice Address - Fax:317-818-0720
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004572A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1260076080OtherDRIVER'S LIC