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General NPI Number Information
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NPI Number | 1770324493
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Entity Type | Organization
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Legal Business Name | ASHLEY LARISEY SPEECH SERVICES PLLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 12400 S HARLEM AVE STE 2NE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1440
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Country | US
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Telephone | 312-298-9003
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Fax | 877-920-1765
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Provider Business Mailing Address
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Address Line | 10040 S FAIRFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60655-1640
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Country | US
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Telephone | 316-519-0531
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY LARISEY
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Credential | M.S., CCC-SLP/L
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Telephone | 316-519-0531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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