Provider Demographics
NPI:1609103100
Name:LYONS, ASHLEY L (MA, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:L
Last Name:LYONS
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CAWFIELD LN
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1637
Mailing Address - Country:US
Mailing Address - Phone:631-806-6245
Mailing Address - Fax:
Practice Address - Street 1:49 CAWFIELD LN
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1637
Practice Address - Country:US
Practice Address - Phone:631-806-6245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019438-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist