Healthcare Provider Details

I. General information

NPI: 1457614299
Provider Name (Legal Business Name): ASHLEY GUEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 COMMONS CIR STE B
YUKON OK
73099-9538
US

IV. Provider business mailing address

301 CLEMENTINE RD
YUKON OK
73099-4208
US

V. Phone/Fax

Practice location:
  • Phone: 405-467-6782
  • Fax:
Mailing address:
  • Phone: 405-203-5285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: