Provider Demographics
NPI:1457452575
Name:HYLTON, ASHLEY WARD (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:WARD
Last Name:HYLTON
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4438 PAMPLICO HWY
Mailing Address - Street 2:GENESIS REHABILITATION
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-8502
Mailing Address - Country:US
Mailing Address - Phone:843-665-4955
Mailing Address - Fax:843-669-8577
Practice Address - Street 1:4438 PAMPLICO HWY
Practice Address - Street 2:GENESIS REHABILITATION
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-8502
Practice Address - Country:US
Practice Address - Phone:843-665-4955
Practice Address - Fax:843-669-8577
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3169235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0334Medicaid
SC420051Medicare ID - Type UnspecifiedMCLEOD HEALTH
SCSA0469Medicare ID - Type UnspecifiedMCLEOD REHAB INDIVIDUAL #