Provider Demographics
NPI:1134418163
Name:VIG, ASHLEY MARIE (MA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:VIG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44744 101ST ST
Mailing Address - Street 2:
Mailing Address - City:LIDGERWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58053-9317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:102 6TH ST. SE
Practice Address - Street 2:
Practice Address - City:HANKINSON
Practice Address - State:ND
Practice Address - Zip Code:58041-9317
Practice Address - Country:US
Practice Address - Phone:701-242-7031
Practice Address - Fax:701-242-8202
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8702235Z00000X
ND1152235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist