Provider Demographics
NPI:1063237352
Name:WOLFORD, ASHLYN (SLP)
Entity type:Individual
Prefix:MISS
First Name:ASHLYN
Middle Name:
Last Name:WOLFORD
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 1:4007 MEANDER PL UNIT 204
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5266
Mailing Address - Country:US
Mailing Address - Phone:321-626-2415
Mailing Address - Fax:
Practice Address - Street 1:4007 MEANDER PL UNIT 204
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5266
Practice Address - Country:US
Practice Address - Phone:321-626-2415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist