MEDICARE: MRS. ASHLEY MARIE WHITAKER M.S. 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	3472	KY

General Provider Information

NPI Number	:	1447589973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY MARIE WHITAKER M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	3293 ORCHARD GRASS RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-8639
Country	:	US
Telephone Number	:	859-523-1930
Fax Number	:

Provider Business Practice Location Address
First Line	:	3293 ORCHARD GRASS RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-8639
Country	:	US
Telephone Number	:	859-523-1930
Fax Number	:

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

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	12/11/2009

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Directions to “ MRS. ASHLEY MARIE WHITAKER M.S. CCC-SLP” Practice Location

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