Provider Demographics
NPI:1558925628
Name:WATJE, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WATJE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:CROUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1229 TOTEROS DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-6950
Mailing Address - Country:US
Mailing Address - Phone:704-649-4509
Mailing Address - Fax:704-843-9045
Practice Address - Street 1:1229 TOTEROS DR
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-6950
Practice Address - Country:US
Practice Address - Phone:704-649-4509
Practice Address - Fax:704-843-9045
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13458235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist