Provider Demographics
NPI:1265875009
Name:FURMAN, ASHLEY ANN (COTA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ANN
Last Name:FURMAN
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 1:5517 E CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-8935
Mailing Address - Country:US
Mailing Address - Phone:262-379-0012
Mailing Address - Fax:
Practice Address - Street 1:709 MEADOW PARK DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:WI
Practice Address - Zip Code:53525-9777
Practice Address - Country:US
Practice Address - Phone:608-676-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4775-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant