Provider Demographics
NPI:1699228726
Name:SHAIN, ASHLEE
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:SHAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:
Other - Last Name:COUTU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8348 TRAFORD LN
Mailing Address - Street 2:SUIE 200
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1663
Mailing Address - Country:US
Mailing Address - Phone:703-569-7500
Mailing Address - Fax:703-866-0158
Practice Address - Street 1:8348 TRAFORD LN
Practice Address - Street 2:SUIE 200
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1663
Practice Address - Country:US
Practice Address - Phone:703-569-7500
Practice Address - Fax:703-866-0158
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist