Provider Demographics
NPI:1104158120
Name:STONE, ASHLEY MARIE (BA, MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:STONE
Suffix:
Gender:F
Credentials:BA, MS, CCC-SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, MS, CCC-SLP
Mailing Address - Street 1:4142 WILLOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-2327
Mailing Address - Country:US
Mailing Address - Phone:315-622-1305
Mailing Address - Fax:
Practice Address - Street 1:1744 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1902
Practice Address - Country:US
Practice Address - Phone:315-468-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0195871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist