Provider Demographics
NPI:1871101220
Name:COOK, ASHTIN PAIGE (SLP)
Entity type:Individual
Prefix:
First Name:ASHTIN
Middle Name:PAIGE
Last Name:COOK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:DIBOLL
Mailing Address - State:TX
Mailing Address - Zip Code:75941-1701
Mailing Address - Country:US
Mailing Address - Phone:936-671-3271
Mailing Address - Fax:
Practice Address - Street 1:215 N TEMPLE DR
Practice Address - Street 2:
Practice Address - City:DIBOLL
Practice Address - State:TX
Practice Address - Zip Code:75941-1701
Practice Address - Country:US
Practice Address - Phone:936-671-3271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2025-10-29
Deactivation Date:2025-09-19
Deactivation Code:
Reactivation Date:2025-10-17
Provider Licenses
StateLicense IDTaxonomies
TX124033235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty