MEDICARE: MRS. ASHLEY HILLIER GRYSKIEWICZ M.S.C.C.C.-S.L.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	41YS00338200	NJ

General Provider Information

NPI Number	:	1861607731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY HILLIER GRYSKIEWICZ M.S.C.C.C.-S.L.P.

Provider Business Mailing Address
First Line	:	12 OXFORD CT
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-2905
Country	:	US
Telephone Number	:	856-719-8385
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 NORTHPOINTE CIR
Second Line	:	SUITE 302
City	:	SEVEN FIELDS
State	:	PA
Zip	:	16046-7861
Country	:	US
Telephone Number	:	800-815-8577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2007
Last Update Date	:	07/08/2007

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