Provider Demographics
NPI:1811206220
Name:MAHONEY, ASHLEIGH EATON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:EATON
Last Name:MAHONEY
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 1:1116 MERLIN DR
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-1604
Mailing Address - Country:US
Mailing Address - Phone:603-661-5564
Mailing Address - Fax:
Practice Address - Street 1:1116 MERLIN DR
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-1604
Practice Address - Country:US
Practice Address - Phone:603-661-5564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-03
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018972-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist