Healthcare Provider Details

I. General information

NPI: 1528535101
Provider Name (Legal Business Name): ASHLEY JEANNETTE HOTCHKISS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 N MACOMB ST
MONROE MI
48162-7815
US

IV. Provider business mailing address

718 N MACOMB ST
MONROE MI
48162-7815
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101004615
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: