Provider Demographics
NPI:1487261764
Name:COLLINS, ASHLI TAYLOR (OTR/L)
Entity type:Individual
Prefix:
First Name:ASHLI
Middle Name:TAYLOR
Last Name:COLLINS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 E ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-5401
Mailing Address - Country:US
Mailing Address - Phone:423-317-7772
Mailing Address - Fax:423-317-7773
Practice Address - Street 1:1615 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-5401
Practice Address - Country:US
Practice Address - Phone:423-317-7772
Practice Address - Fax:423-317-7773
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6452OtherLICENSE NUMBER