Provider Demographics
NPI:1891048989
Name:CANNON, ASHLEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:CANNON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21191 KUYKENDAHL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3307
Mailing Address - Country:US
Mailing Address - Phone:281-376-1188
Mailing Address - Fax:281-376-5944
Practice Address - Street 1:21191 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3307
Practice Address - Country:US
Practice Address - Phone:281-376-1188
Practice Address - Fax:281-376-5944
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80456231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist