Provider Demographics
NPI:1417694100
Name:ASKEW, ALISA (SLP)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:ASKEW
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 GAHANNA HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7016
Mailing Address - Country:US
Mailing Address - Phone:614-623-5042
Mailing Address - Fax:
Practice Address - Street 1:403 LIBERTY WAY
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3501
Practice Address - Country:US
Practice Address - Phone:740-513-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20211669235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist