Provider Demographics
NPI:1942552864
Name:LICHTER, ASHLEY MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:LICHTER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:CARLBORG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:8101 N OVERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2821
Mailing Address - Country:US
Mailing Address - Phone:847-477-5668
Mailing Address - Fax:
Practice Address - Street 1:241 GOLF MILL CTR STE 201-203
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1224
Practice Address - Country:US
Practice Address - Phone:847-699-9757
Practice Address - Fax:847-699-5037
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242002493235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist