Provider Demographics
NPI:1912230640
Name:PURDUM, ASHLEY ANN
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ANN
Last Name:PURDUM
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:GLUSZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5015 E 29TH ST N # DOORT
Mailing Address - Street 2:EVELYN H. CASSAT SPEECH-LANGUAGE HEARING CLINIC
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-2110
Mailing Address - Country:US
Mailing Address - Phone:316-978-3289
Mailing Address - Fax:
Practice Address - Street 1:5015 E 29TH ST N # DOORT
Practice Address - Street 2:EVELYN H. CASSAT SPEECH-LANGUAGE HEARING CLINIC
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220-2110
Practice Address - Country:US
Practice Address - Phone:316-978-3289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1346235Z00000X
KS3169235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist