Provider Demographics
NPI:1780026054
Name:BREWER, ASHLEY J (MED, SLP-A)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:BREWER
Suffix:
Gender:F
Credentials:MED, SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 NORTH CAMELBACK ROAD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1646
Mailing Address - Country:US
Mailing Address - Phone:602-621-0138
Mailing Address - Fax:
Practice Address - Street 1:530 E ROSE LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1247
Practice Address - Country:US
Practice Address - Phone:602-621-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA82762355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant