Healthcare Provider Details

I. General information

NPI: 1366232175
Provider Name (Legal Business Name): ASHLEY NICOLE BOGDON MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 VALLEY BROOK RD
MC MURRAY PA
15317-3338
US

IV. Provider business mailing address

308 MONTEVERDI DR
OAKDALE PA
15071-1758
US

V. Phone/Fax

Practice location:
  • Phone: 724-942-8150
  • Fax:
Mailing address:
  • Phone: 412-491-8578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL009984
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: