Individual
MRS. ASHLEY ELLIOTT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
612 CORNELIA CT, FRANKLIN, TN 37064-4217
(615) 788-0492
(615) 628-8107
Mailing address
612 CORNELIA CT, FRANKLIN, TN 37064-4217
(615) 788-0492
(615) 628-8107
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
111292
TX
225XP0200X
Pediatric Occupational Therapist
Primary
4595
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045JN
BLUE CROSS BLUE SHEILD ID
TX
01
—
050551331
TAX ID FOR CLINIC
TX
05
—
1530816
—
TN
Enumeration date
11/17/2006
Last updated
09/29/2015
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