Ashley Anne Brack
Individual provider Active NPI Speech-Language Pathologist · Providence, RI
NPI 1760627236 · NPPES record last updated Nov 12, 2010
Key facts
- NPI
- 1760627236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP01040 (RI)
- Practice address
- 765 Allens Ave
Suite 110
Providence, RI 02905-5443 - Phone
- (401) 444-3201
- Fax
- (401) 444-8507
- NPI assigned
- Dec 11, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP01040 | RI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP01040 | RI | Yes |
Addresses
Primary practice location
765 Allens Ave
Suite 110
Providence, RI 02905-5443
Mailing address
765 Allens Ave
Suite 110
Providence, RI 02905-5443
Phone (401) 444-3201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP01040 | Other | RI | LICENSE |
Other providers in Providence, RI
- Margaret Mary Boyle
- Sarah F. Boyle
- Sean Boyle
- Mary Elizabeth Boynton
- Brace Medical Supply
- Rebecca Diane Braden
- William Braden
- Diana L Bradford
- Nicholas Bradford
- Matthew Bradley
All providers in Providence, RI · Speech-Language Pathologist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.