Provider Demographics
NPI:1356969182
Name:SANDIFER, ASHLEY LECATES (AUD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:LECATES
Last Name:SANDIFER
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 1:1100 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-5821
Mailing Address - Country:US
Mailing Address - Phone:662-329-7270
Mailing Address - Fax:
Practice Address - Street 1:1253 EASTOVER DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-6315
Practice Address - Country:US
Practice Address - Phone:601-502-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4655231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist