Provider Demographics
NPI:1215350673
Name:CLINE, ASHLEY SMALL (MCD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SMALL
Last Name:CLINE
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MC COLL
Mailing Address - State:SC
Mailing Address - Zip Code:29570-2522
Mailing Address - Country:US
Mailing Address - Phone:843-523-5371
Mailing Address - Fax:
Practice Address - Street 1:700 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MC COLL
Practice Address - State:SC
Practice Address - Zip Code:29570-2522
Practice Address - Country:US
Practice Address - Phone:843-523-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist