Provider Demographics
NPI:1467122267
Name:DAVIS, ASHLEY LORIN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LORIN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7600 CABOT DR APT 1216
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4391
Mailing Address - Country:US
Mailing Address - Phone:352-875-6235
Mailing Address - Fax:
Practice Address - Street 1:5203 MARYLAND WAY STE 104
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5022
Practice Address - Country:US
Practice Address - Phone:615-560-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14322990OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION (ASHA)
TN7737OtherTENNESSEE BOARD OF COMMUNICATION DISORDERS & SCIENCE