MEDICARE: ASHLEY HIGSON M.S.P., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	12392	NC

General Provider Information

NPI Number	:	1114379419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY HIGSON M.S.P., CCC-SLP

Provider Business Mailing Address
First Line	:	1356 WEYMOUTH LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-9770
Country	:	US
Telephone Number	:	704-526-9707
Fax Number	:

Provider Business Practice Location Address
First Line	:	1356 WEYMOUTH LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-9770
Country	:	US
Telephone Number	:	704-526-9707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2016
Last Update Date	:	05/25/2021

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Directions to “ ASHLEY HIGSON M.S.P., CCC-SLP” Practice Location

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