Healthcare Provider Details

I. General information

NPI: 1265133482
Provider Name (Legal Business Name): ASHTON HAGER MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 S STATE ROAD 145
FRENCH LICK IN
47432-1036
US

IV. Provider business mailing address

1111 SW 2ND ST
LOOGOOTEE IN
47553-1859
US

V. Phone/Fax

Practice location:
  • Phone: 812-936-9991
  • Fax:
Mailing address:
  • Phone: 812-444-9358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: