Basic Information
Provider Information
NPI: 1467061523
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIPPEL
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7335 W GRANT RANCH BLVD APT 412
Address2:  
City: LITTLETON
State: CO
PostalCode: 801232645
CountryCode: US
TelephoneNumber: 7855319497
FaxNumber:  
Practice Location
Address1: 1573 S CATAWBA CIR
Address2:  
City: AURORA
State: CO
PostalCode: 800186012
CountryCode: US
TelephoneNumber: 7204739791
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/24/2020
LastUpdateDate: 07/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT.0006472COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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