Provider Demographics
NPI:1629396361
Name:ASHCRAFT, MARY B
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:B
Last Name:ASHCRAFT
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 1:5219 CONGRESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-3485
Mailing Address - Country:US
Mailing Address - Phone:501-319-3950
Mailing Address - Fax:
Practice Address - Street 1:10515 W MARKHAM
Practice Address - Street 2:SUITEK-2
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-823-0572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist