Healthcare Provider Details

I. General information

NPI: 1841134780
Provider Name (Legal Business Name): ASHLEY KRAKER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 E MAIN ST STE 109
BEXLEY OH
43209-2581
US

IV. Provider business mailing address

PO BOX 291
ETNA OH
43018-0291
US

V. Phone/Fax

Practice location:
  • Phone: 740-490-2414
  • Fax: 740-860-4686
Mailing address:
  • Phone: 740-490-2414
  • Fax: 740-860-4686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCOND.20253079-SP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: