Individual
MRS. ASHLEY BROOKE LILLY-QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
100 PARK STREET, PINEVILLE, WV 24874
(304) 732-6262
(304) 732-7226
Mailing address
PO BOX 745, OAK HILL, WV 25901-0745
(304) 465-8068
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1234
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003848
—
WV
Enumeration date
03/29/2007
Last updated
02/04/2009
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