Provider Demographics
NPI:1346733672
Name:MASTERSON, ASHLI (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLI
Middle Name:
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 JONES RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-4337
Mailing Address - Country:US
Mailing Address - Phone:618-384-6640
Mailing Address - Fax:
Practice Address - Street 1:200 N HICKORY ST
Practice Address - Street 2:
Practice Address - City:GALATIA
Practice Address - State:IL
Practice Address - Zip Code:62935-1034
Practice Address - Country:US
Practice Address - Phone:618-297-4570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist