Provider Demographics
NPI:1609445469
Name:LEFRINGHOUSE, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LEFRINGHOUSE
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 1:2118 N 900TH AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:IL
Mailing Address - Zip Code:62347-2119
Mailing Address - Country:US
Mailing Address - Phone:217-617-9100
Mailing Address - Fax:
Practice Address - Street 1:1313 PRATT ST
Practice Address - Street 2:
Practice Address - City:BARRY
Practice Address - State:IL
Practice Address - Zip Code:62312-1365
Practice Address - Country:US
Practice Address - Phone:217-335-2326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242006365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty