Provider Demographics
NPI:1639768864
Name:MARSHALL, ASHLEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5360 TANGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-4510
Mailing Address - Country:US
Mailing Address - Phone:317-796-9595
Mailing Address - Fax:
Practice Address - Street 1:5360 TANGLEWOOD LN
Practice Address - Street 2:
Practice Address - City:WHITESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46075-4510
Practice Address - Country:US
Practice Address - Phone:317-796-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005377A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist