Provider Demographics
NPI:1245696442
Name:ASHLEY, DAWN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:ANGELE
Other - Last Name:ASHLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:21005 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-2243
Mailing Address - Country:US
Mailing Address - Phone:504-390-8750
Mailing Address - Fax:
Practice Address - Street 1:3215 CUMING ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2000
Practice Address - Country:US
Practice Address - Phone:402-557-2367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist