Provider Demographics
NPI:1891129904
Name:WOODALL, ASHLEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:WOODALL
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 1:5608 PARKCREST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4972
Mailing Address - Country:US
Mailing Address - Phone:512-345-4664
Mailing Address - Fax:
Practice Address - Street 1:5608 PARKCREST DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4972
Practice Address - Country:US
Practice Address - Phone:512-345-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80523231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist