Provider Demographics
NPI:1720649908
Name:PAPPAS, ASHLEY NICOLE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:MAINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFY-SLP
Mailing Address - Street 1:1780 SMOKEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-3086
Mailing Address - Country:US
Mailing Address - Phone:954-805-2510
Mailing Address - Fax:
Practice Address - Street 1:1780 SMOKEY RD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-3086
Practice Address - Country:US
Practice Address - Phone:954-805-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010291235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist