Provider Demographics
NPI:1184403909
Name:JAMES, ASHLEY WORDEN (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:WORDEN
Last Name:JAMES
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 1:322 WAGON TRAIL AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745
Mailing Address - Country:US
Mailing Address - Phone:501-353-3627
Mailing Address - Fax:
Practice Address - Street 1:1200 W PERRY ROAD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72748-2522
Practice Address - Country:US
Practice Address - Phone:479-267-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR14429809235Z00000X
AR202449235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14429809OtherASHA