Provider Demographics
NPI:1124463765
Name:BLOODSWORTH, ASHLEY JAMES (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:JAMES
Last Name:BLOODSWORTH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:300 FAULKNER DRIVE
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-4453
Mailing Address - Country:US
Mailing Address - Phone:251-937-9881
Mailing Address - Fax:251-937-9804
Practice Address - Street 1:300 FAULKNER DR
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-2771
Practice Address - Country:US
Practice Address - Phone:251-937-9881
Practice Address - Fax:251-937-9804
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist