MEDICARE: OLIVIA ANN ASH M.A. 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	8400	SC

General Provider Information

NPI Number	:	1275218570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA ANN ASH M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	211 PRATHER PARK DR UNIT B
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-7983
Country	:	US
Telephone Number	:	843-640-5522
Fax Number	:	855-817-2129

Provider Business Practice Location Address
First Line	:	211 PRATHER PARK DR UNIT B
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-7983
Country	:	US
Telephone Number	:	843-640-5522
Fax Number	:	855-817-2129

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

Provider Enumeration Date	:	06/15/2023
Last Update Date	:	12/14/2025

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