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General NPI Number Information
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NPI Number | 1144049305
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Entity Type | Individual
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Provider Name | ASHLEY PECK
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Gender | Female
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Dates
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Enumeration Date | 10/05/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 287 E HUNT HWY STE 102
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-5096
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Country | US
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Telephone | 623-888-9118
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Fax |
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Provider Business Mailing Address
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Address Line | 447 E JEANNE LN
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-4178
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Country | US
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Telephone | 623-888-9118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA15723
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License Number State | AZ
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