Provider Demographics
NPI:1295911659
Name:SHAW, ASHLEY LYNNE GOLDEN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LYNNE GOLDEN
Last Name:SHAW
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7007 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3104
Mailing Address - Country:US
Mailing Address - Phone:956-661-0475
Mailing Address - Fax:956-630-9941
Practice Address - Street 1:7007 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3104
Practice Address - Country:US
Practice Address - Phone:956-661-0475
Practice Address - Fax:956-630-9941
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103905235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist