Provider Demographics
NPI:1457572737
Name:MOODY, ASHLEY MEEKER (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MEEKER
Last Name:MOODY
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:18103 MANNING DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-5673
Mailing Address - Country:US
Mailing Address - Phone:225-622-6695
Mailing Address - Fax:225-791-2891
Practice Address - Street 1:8128 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7865
Practice Address - Country:US
Practice Address - Phone:225-791-8666
Practice Address - Fax:225-791-2891
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4561235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist