Provider Demographics
NPI:1255619748
Name:THOM, ASHLEY BOYNTON (AUD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BOYNTON
Last Name:THOM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EXCHANGE PL
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2580
Mailing Address - Country:US
Mailing Address - Phone:337-291-9939
Mailing Address - Fax:337-291-9023
Practice Address - Street 1:110 EXCHANGE PL
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2580
Practice Address - Country:US
Practice Address - Phone:337-291-9939
Practice Address - Fax:337-291-9023
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6508237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter