Provider Demographics
NPI:1063643427
Name:LAWLOR, ASHLEY N (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:N
Last Name:LAWLOR
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 1:1928 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-9152
Mailing Address - Country:US
Mailing Address - Phone:419-681-2852
Mailing Address - Fax:
Practice Address - Street 1:1210 E BOGART RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-6411
Practice Address - Country:US
Practice Address - Phone:419-681-2852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2009203-SP235Z00000X
OHSP 9616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3400000Medicaid