Provider Demographics
NPI:1598374886
Name:MACY, ASHLEY ELAINE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELAINE
Last Name:MACY
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 1:7721 BLACK WILLOW
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-3601
Mailing Address - Country:US
Mailing Address - Phone:315-744-2831
Mailing Address - Fax:
Practice Address - Street 1:8395 OSWEGO RD
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-6801
Practice Address - Country:US
Practice Address - Phone:315-450-4898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist