Provider Demographics
NPI:1043765340
Name:MALONE, ASHLEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MALONE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 ATTLEBORO RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3806
Mailing Address - Country:US
Mailing Address - Phone:336-451-1709
Mailing Address - Fax:
Practice Address - Street 1:3216 ATTLEBORO RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3806
Practice Address - Country:US
Practice Address - Phone:336-451-1709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010739235Z00000X
NC4934235Z00000X
CA19713235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist