Healthcare Provider Details

I. General information

NPI: 1891186532
Provider Name (Legal Business Name): ASHLEY HANSEN M.S., SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 S SHOSHONE ST
BOISE ID
83705-1750
US

IV. Provider business mailing address

604 S SHOSHONE ST
BOISE ID
83705-1750
US

V. Phone/Fax

Practice location:
  • Phone: 208-409-5318
  • Fax:
Mailing address:
  • Phone: 208-409-5318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP-2953
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: