Provider Demographics
NPI:1073257085
Name:PINGSTERHAUS, ASHLY BROOKE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLY
Middle Name:BROOKE
Last Name:PINGSTERHAUS
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 1:6312 73RD ST APT 916
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1962
Mailing Address - Country:US
Mailing Address - Phone:214-310-7184
Mailing Address - Fax:
Practice Address - Street 1:210 WEST AVE
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-3233
Practice Address - Country:US
Practice Address - Phone:806-894-5053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist