Provider Demographics
NPI:1700114808
Name:MORA, ASHLEY (MA- CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MORA
Suffix:
Gender:F
Credentials:MA- CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8470 BUCKHORN PARKE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6323
Mailing Address - Country:US
Mailing Address - Phone:956-376-9804
Mailing Address - Fax:
Practice Address - Street 1:106 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6846
Practice Address - Country:US
Practice Address - Phone:956-425-3338
Practice Address - Fax:956-425-3339
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12801931235Z00000X
TX105417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist