Provider Demographics
NPI:1609235654
Name:NEALIS, ASHLEE (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:NEALIS
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 SANDY BROOK DR
Mailing Address - Street 2:STE 201
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1516
Mailing Address - Country:US
Mailing Address - Phone:512-388-8904
Mailing Address - Fax:512-287-4214
Practice Address - Street 1:4010 SANDY BROOK DR
Practice Address - Street 2:STE 201
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1516
Practice Address - Country:US
Practice Address - Phone:512-388-8904
Practice Address - Fax:512-287-4214
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist