Provider Demographics
NPI:1922498146
Name:ELLIS, ASHLEY DANIELLE (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:DANIELLE
Last Name:ELLIS
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8307
Mailing Address - Country:US
Mailing Address - Phone:832-876-9290
Mailing Address - Fax:
Practice Address - Street 1:3000 WESLAYAN ST STE 275
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5751
Practice Address - Country:US
Practice Address - Phone:713-218-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist