Provider Demographics
NPI:1992233241
Name:MASHBURN, ASHLI KRISTINE (HIS)
Entity type:Individual
Prefix:
First Name:ASHLI
Middle Name:KRISTINE
Last Name:MASHBURN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 JOHNSTON ST UNIT 502
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5334
Mailing Address - Country:US
Mailing Address - Phone:903-838-3093
Mailing Address - Fax:903-838-8773
Practice Address - Street 1:4522 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2740
Practice Address - Country:US
Practice Address - Phone:903-838-3093
Practice Address - Fax:903-838-8773
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80728237700000X
LA1283237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist