Provider Demographics
NPI:1316322621
Name:KYLER, ASHLEY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KYLER
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 1:9426 TOWNSEND RD
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39352-6724
Mailing Address - Country:US
Mailing Address - Phone:601-480-1141
Mailing Address - Fax:
Practice Address - Street 1:306 WASHINGTON ST SOUTH
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:AL
Practice Address - Zip Code:35470
Practice Address - Country:US
Practice Address - Phone:205-575-1609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3810235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist