Provider Demographics
NPI:1124881800
Name:NUNN, ASHLEY (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:NUNN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MUETZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1441 WESTSIDE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24017-2799
Mailing Address - Country:US
Mailing Address - Phone:813-601-0822
Mailing Address - Fax:
Practice Address - Street 1:1441 WESTSIDE BLVD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-2799
Practice Address - Country:US
Practice Address - Phone:813-601-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist