Provider Demographics
NPI:1619232188
Name:BELSTLE, ASHLEY DIANE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DIANE
Last Name:BELSTLE
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 1:926 KWIX RD
Mailing Address - Street 2:SPECIAL SERVICES - CLAIM CARE
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-3813
Mailing Address - Country:US
Mailing Address - Phone:660-269-2600
Mailing Address - Fax:660-269-2611
Practice Address - Street 1:926 KWIX RD
Practice Address - Street 2:SPECIAL SERVICES - CLAIM CARE
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-3813
Practice Address - Country:US
Practice Address - Phone:660-269-2600
Practice Address - Fax:660-269-2611
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010027723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist