Basic Information
| Provider Information | |||||||||
| NPI: | 1447579560 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WAKEFIELD | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 WILDWOOD ROAD | ||||||||
| Address2: | |||||||||
| City: | GIBSONIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124877771 | ||||||||
| FaxNumber: | 4124877772 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 WILDWOOD ROAD | ||||||||
| Address2: | |||||||||
| City: | ALLISON PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124877771 | ||||||||
| FaxNumber: | 4124877772 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2010 | ||||||||
| LastUpdateDate: | 10/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC011423 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.