Provider Demographics
NPI:1215216031
Name:PEREZ, ASHLEY NICOLE (AUD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:PEREZ
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 W JAMES M CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4674
Mailing Address - Country:US
Mailing Address - Phone:931-540-4259
Mailing Address - Fax:931-540-4260
Practice Address - Street 1:1222 TROTWOOD AVE STE 305
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6405
Practice Address - Country:US
Practice Address - Phone:931-540-4259
Practice Address - Fax:931-540-4260
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2161231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist