Provider Demographics
NPI:1013312198
Name:STEVENS, ASHELY HOPE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASHELY
Middle Name:HOPE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ASHELY
Other - Middle Name:HOPE
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12899 E 76TH ST N STE 109
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-4059
Mailing Address - Country:US
Mailing Address - Phone:918-609-6003
Mailing Address - Fax:918-609-6002
Practice Address - Street 1:12899 E 76TH ST N STE 109
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4059
Practice Address - Country:US
Practice Address - Phone:918-609-6003
Practice Address - Fax:918-609-6002
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist