Provider Demographics
NPI:1558511758
Name:ASHWORTH, PAMELA LEIGH
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LEIGH
Last Name:ASHWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 HIGHWAY 60 E
Mailing Address - Street 2:
Mailing Address - City:BIGELOW
Mailing Address - State:AR
Mailing Address - Zip Code:72016-5069
Mailing Address - Country:US
Mailing Address - Phone:501-759-2825
Mailing Address - Fax:
Practice Address - Street 1:4319 HIGHWAY 60 E
Practice Address - Street 2:
Practice Address - City:BIGELOW
Practice Address - State:AR
Practice Address - Zip Code:72016-5069
Practice Address - Country:US
Practice Address - Phone:501-759-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1813235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist