Provider Demographics
NPI:1699289439
Name:SMITH, ASHLEY LAUREN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAUREN
Last Name:SMITH
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 1:780 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-6192
Mailing Address - Country:US
Mailing Address - Phone:630-819-9522
Mailing Address - Fax:
Practice Address - Street 1:1560 WESTGLEN DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-1369
Practice Address - Country:US
Practice Address - Phone:630-428-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist