Provider Demographics
NPI:1003219783
Name:CUBBAGE, ASHLEY (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:CUBBAGE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:SCALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1536 FORDING ISLAND RD STE 105
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1144
Mailing Address - Country:US
Mailing Address - Phone:240-418-8864
Mailing Address - Fax:
Practice Address - Street 1:1536 FORDING ISLAND RD STE 105
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1144
Practice Address - Country:US
Practice Address - Phone:240-418-8864
Practice Address - Fax:843-837-2081
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist