Provider Demographics
NPI:1376207043
Name:KOSPELICH, ASHLEY (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KOSPELICH
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 1:405 TULLULAH AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-1151
Mailing Address - Country:US
Mailing Address - Phone:985-233-9487
Mailing Address - Fax:
Practice Address - Street 1:405 TULLULAH AVE
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-1151
Practice Address - Country:US
Practice Address - Phone:985-233-9487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7277235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist