Provider Demographics
NPI:1932767571
Name:EDWARDS BELL, ASHLEY COURTNEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:COURTNEY
Last Name:EDWARDS BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 N HENRY BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3261
Mailing Address - Country:US
Mailing Address - Phone:678-889-3349
Mailing Address - Fax:800-948-2944
Practice Address - Street 1:5473 N HENRY BLVD STE 4
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3261
Practice Address - Country:US
Practice Address - Phone:678-889-3349
Practice Address - Fax:800-948-2944
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010205235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist