Provider Demographics
NPI:1568883866
Name:ASHFORD, AUDREY (MA)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:
Last Name:ASHFORD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:ANDRYSIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:831 NW 58TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-1319
Mailing Address - Country:US
Mailing Address - Phone:305-244-6148
Mailing Address - Fax:305-758-3462
Practice Address - Street 1:831 NW 58TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-1319
Practice Address - Country:US
Practice Address - Phone:305-244-6148
Practice Address - Fax:305-758-3462
Is Sole Proprietor?:No
Enumeration Date:2014-01-04
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist