Provider Demographics
NPI:1255887204
Name:WIESSING, ASHLEE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:WIESSING
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:
Other - Last Name:WINGERTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1513 GREENFIELD CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7471
Mailing Address - Country:US
Mailing Address - Phone:573-768-9925
Mailing Address - Fax:
Practice Address - Street 1:4812 SANTANA CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7138
Practice Address - Country:US
Practice Address - Phone:573-639-2279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016030817235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist