Provider Demographics
NPI:1063655512
Name:MADDEN, ASHLEY MARIE D'AMOUR (MS CCC/SLP, LIC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE D'AMOUR
Last Name:MADDEN
Suffix:
Gender:F
Credentials:MS CCC/SLP, LIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BARKER ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534
Mailing Address - Country:US
Mailing Address - Phone:585-267-1000
Mailing Address - Fax:
Practice Address - Street 1:75 BARKER ROAD
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534
Practice Address - Country:US
Practice Address - Phone:585-267-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018995-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist