1053636712 NPI number — MRS. ASHLEY DIONE FERNANDEZ ASHLEY FERNANDEZ,SLP

Table of content: MRS. ASHLEY DIONE FERNANDEZ ASHLEY FERNANDEZ,SLP (NPI 1053636712)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053636712 NPI number — MRS. ASHLEY DIONE FERNANDEZ ASHLEY FERNANDEZ,SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ
Provider First Name:
ASHLEY
Provider Middle Name:
DIONE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ASHLEY FERNANDEZ,SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GLASPER
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
DIONE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
ASHLEY GLASPER, SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1053636712
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35182 FERNANDEZ DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DONALDSONVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70346-7202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35182 FERNANDEZ DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DONALDSONVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70346-7202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-200-4303
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  6079 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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