Provider Demographics
NPI:1295163616
Name:LOGAN, ASHLEY (CF-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LOGAN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 KY 3436
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-7434
Mailing Address - Country:US
Mailing Address - Phone:606-344-6761
Mailing Address - Fax:
Practice Address - Street 1:2150 LEXINGTON RD
Practice Address - Street 2:SUITE G
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7924
Practice Address - Country:US
Practice Address - Phone:859-333-8147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist