Provider Demographics
NPI:1053820225
Name:MCDANIELS, ASHLEY MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE
Last Name:MCDANIELS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:ERWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:320 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SOMONAUK
Mailing Address - State:IL
Mailing Address - Zip Code:60552-9793
Mailing Address - Country:US
Mailing Address - Phone:815-498-2338
Mailing Address - Fax:
Practice Address - Street 1:320 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SOMONAUK
Practice Address - State:IL
Practice Address - Zip Code:60552-9793
Practice Address - Country:US
Practice Address - Phone:815-498-2338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012585235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist