Provider Demographics
NPI:1699915793
Name:ASH, KELLI ANN (SLP)
Entity type:Individual
Prefix:MS
First Name:KELLI
Middle Name:ANN
Last Name:ASH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10610 METRIC DR
Mailing Address - Street 2:#101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5581
Mailing Address - Country:US
Mailing Address - Phone:214-221-4405
Mailing Address - Fax:214-221-4463
Practice Address - Street 1:10610 METRIC DR
Practice Address - Street 2:#101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5581
Practice Address - Country:US
Practice Address - Phone:214-221-4405
Practice Address - Fax:214-221-4463
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist