Individual
ASHLEY CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 S STATE ROUTE 100, TIFFIN, OH 44883-9356
(419) 447-7203
Mailing address
2550 S STATE ROUTE 100, TIFFIN, OH 44883-9356
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.04920
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA.04920
LICENSE NUMBER
OH
Enumeration date
08/30/2015
Last updated
08/31/2015
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