Provider Demographics
NPI:1194170316
Name:HEATH, ASHLI B (MCD, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ASHLI
Middle Name:B
Last Name:HEATH
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 LONE OAK CT
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8391
Mailing Address - Country:US
Mailing Address - Phone:803-397-0735
Mailing Address - Fax:
Practice Address - Street 1:42 LONE OAK CT
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8391
Practice Address - Country:US
Practice Address - Phone:803-397-0735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5019235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist