Provider Demographics
NPI:1194966044
Name:KIRK, ASHLEY MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:MARIE
Last Name:KIRK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 GROVEMONT DR APT F8
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-8492
Mailing Address - Country:US
Mailing Address - Phone:252-341-4198
Mailing Address - Fax:
Practice Address - Street 1:200 TRADE ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-5055
Practice Address - Country:US
Practice Address - Phone:252-823-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5735235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist