Provider Demographics
NPI:1386861805
Name:ZWEIFEL, ASHELY ANN
Entity type:Individual
Prefix:
First Name:ASHELY
Middle Name:ANN
Last Name:ZWEIFEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:ROGGENKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:100 N THOMPSON AVE
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-0248
Mailing Address - Country:US
Mailing Address - Phone:816-630-9221
Mailing Address - Fax:816-630-9207
Practice Address - Street 1:EXCELSIOR SPRINGS PUBLIC SCHOOLS
Practice Address - Street 2:100 N THOMPSON AVE
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-0248
Practice Address - Country:US
Practice Address - Phone:816-630-9221
Practice Address - Fax:816-630-9207
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005033263235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO467573309Medicaid