Provider Demographics
NPI:1811162134
Name:ASHBY, TAMMY (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:ASHBY
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 WOODLAKE RD
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IL
Mailing Address - Zip Code:61875-9617
Mailing Address - Country:US
Mailing Address - Phone:217-621-3458
Mailing Address - Fax:
Practice Address - Street 1:141 WOODLAKE RD
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IL
Practice Address - Zip Code:61875-9617
Practice Address - Country:US
Practice Address - Phone:217-621-3458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146004622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist