Provider Demographics
NPI:1669955365
Name:ASHBAUGH, ROSEMARY ANNE (SLP)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:ANNE
Last Name:ASHBAUGH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2593 TIDIOUTE ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:TIDIOUTE
Mailing Address - State:PA
Mailing Address - Zip Code:16351-2131
Mailing Address - Country:US
Mailing Address - Phone:814-688-0196
Mailing Address - Fax:
Practice Address - Street 1:701 ROUSE AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16371-1605
Practice Address - Country:US
Practice Address - Phone:814-563-7565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005197L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist