Provider Demographics
NPI:1740703438
Name:RICHBURG, ASHLEY JORDAN (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:JORDAN
Last Name:RICHBURG
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 SANTA CRUZ ST
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-5712
Mailing Address - Country:US
Mailing Address - Phone:806-632-3684
Mailing Address - Fax:
Practice Address - Street 1:3613 WILLIAMS DR STE 406
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-1370
Practice Address - Country:US
Practice Address - Phone:512-704-3911
Practice Address - Fax:512-704-3911
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80876231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty