MEDICARE: ASHLEY TYLER

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

General Provider Information

NPI Number	:	1326552274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY TYLER

Provider Business Mailing Address
First Line	:	491 THACKERAY TRL
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44143-2725
Country	:	US
Telephone Number	:	440-446-0017
Fax Number	:

Provider Business Practice Location Address
First Line	:	19900 CLARE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44137-1806
Country	:	US
Telephone Number	:	216-662-3343
Fax Number	:

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

Provider Enumeration Date	:	11/29/2017
Last Update Date	:	11/29/2017

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Directions to “ ASHLEY TYLER ” Practice Location

Language	Start Address	Practice Location

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