Provider Demographics
NPI:1881065464
Name:GUTHRIE, ASHLEY ANN (MS SLP CCC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4166 MATHEWS DR
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-6908
Mailing Address - Country:US
Mailing Address - Phone:208-240-0270
Mailing Address - Fax:
Practice Address - Street 1:4166 MATHEWS DR
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-6908
Practice Address - Country:US
Practice Address - Phone:208-240-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP2653235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist