Provider Demographics
NPI:1790089621
Name:KUNZ, ASHLEY NICHOLE (SLP-A)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICHOLE
Last Name:KUNZ
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICHOLE
Other - Last Name:ABEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP-A
Mailing Address - Street 1:2271 CARNATION AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-5356
Mailing Address - Country:US
Mailing Address - Phone:951-306-7679
Mailing Address - Fax:
Practice Address - Street 1:2271 CARNATION AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-5356
Practice Address - Country:US
Practice Address - Phone:951-306-7679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14192355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant