MEDICARE: AYESHA ALI CF-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	121719	TX

General Provider Information

NPI Number	:	1164200200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYESHA ALI CF-SLP

Provider Business Mailing Address
First Line	:	6230 N BELT LINE RD STE 300
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2657
Country	:	US
Telephone Number	:	469-320-1700
Fax Number	:	460-320-1732

Provider Business Practice Location Address
First Line	:	6230 N BELT LINE RD STE 300
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2657
Country	:	US
Telephone Number	:	469-320-1700
Fax Number	:	469-320-1700

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

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	01/25/2024

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Directions to “ AYESHA ALI CF-SLP” Practice Location

Language	Start Address	Practice Location

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