Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5109 | TN |
NPI | 1003435769 |
---|---|
Provider Name | Ashley Lynn James |
First Address | Memphis, TN 38114-1755 |
Second Address | Memphis, TN 38114-2534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2020 |
Last Update Date | 13/04/2020 |