Provider Demographics
NPI:1952647729
Name:ASH, MINDY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:ASH
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 1:701 OAK ST
Mailing Address - Street 2:STE C
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-3073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 OAK ST
Practice Address - Street 2:STE C
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3073
Practice Address - Country:US
Practice Address - Phone:806-773-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-22
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106291235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist