Provider Demographics
NPI:1104108604
Name:DUDLEY, ASHLEE NIKOLE (SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEE
Middle Name:NIKOLE
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:NIKOLE
Other - Last Name:FRALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2150 CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7734
Mailing Address - Country:US
Mailing Address - Phone:502-303-8634
Mailing Address - Fax:
Practice Address - Street 1:12862 KY-180
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102
Practice Address - Country:US
Practice Address - Phone:606-928-5805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4396142316235Z00000X
WVSLP-1461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist