Provider Demographics
NPI:1497480198
Name:FIELDS, ASHLEY RENEE (SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:RNEE
Other - Last Name:WINDSOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2741 BRIAROAKS LN
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-9134
Mailing Address - Country:US
Mailing Address - Phone:816-294-3929
Mailing Address - Fax:
Practice Address - Street 1:2741 BRIAROAKS LN
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-9134
Practice Address - Country:US
Practice Address - Phone:816-294-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009024433235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist