Provider Demographics
NPI:1427283845
Name:PAGELOW, ASHLEY MEREDITH (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MEREDITH
Last Name:PAGELOW
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78-80 JACKSON ST
Mailing Address - Street 2:2A
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6147
Mailing Address - Country:US
Mailing Address - Phone:202-557-6663
Mailing Address - Fax:
Practice Address - Street 1:78-80 JACKSON ST
Practice Address - Street 2:2A
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6147
Practice Address - Country:US
Practice Address - Phone:202-557-6663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016823-1235Z00000X
NJ41YS00529600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist