Provider Demographics
NPI:1982045837
Name:HANCOCK, ASHLEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HANCOCK
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 1:1090 22ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3442
Mailing Address - Country:US
Mailing Address - Phone:239-776-9679
Mailing Address - Fax:
Practice Address - Street 1:2590 NORTHBROOKE PLAZA DR STE 308
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8102
Practice Address - Country:US
Practice Address - Phone:754-300-6402
Practice Address - Fax:239-533-9713
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 11356235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102681600Medicaid