Provider Demographics
NPI:1750980009
Name:ASH AUDIOLOGY PLLC
Entity type:Organization
Organization Name:ASH AUDIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:MAGANN FAIVRE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:815-618-8006
Mailing Address - Street 1:2637 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2231
Mailing Address - Country:US
Mailing Address - Phone:815-618-8006
Mailing Address - Fax:
Practice Address - Street 1:2637 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2231
Practice Address - Country:US
Practice Address - Phone:815-618-8006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200617760AMedicaid