Individual
ASHLEY THEOGENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1016 EUCLID AVE, CHARLOTTE, NC 28203-4520
(704) 807-5699
(704) 631-4574
Mailing address
223 HILO DR APT B, CHARLOTTE, NC 28206-4908
(786) 393-2079
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11731
NC
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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