Provider Demographics
NPI:1902056443
Name:HAMLETT, ASHLEY MARTIN (SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARTIN
Last Name:HAMLETT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 LAKE BOONE TRL
Mailing Address - Street 2:STE. 4
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7511
Mailing Address - Country:US
Mailing Address - Phone:919-781-4434
Mailing Address - Fax:
Practice Address - Street 1:4201 LAKE BOONE TRL
Practice Address - Street 2:STE. 4
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7511
Practice Address - Country:US
Practice Address - Phone:919-781-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-21
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8238235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist