MEDICARE: ASHLEY BIRD MS 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

General Provider Information

NPI Number	:	1548558406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY BIRD MS CCC-SLP

Provider Business Mailing Address
First Line	:	8209 KIRKVILLE RD
Second Line	:
City	:	KIRKVILLE
State	:	NY
Zip	:	13082-9702
Country	:	US
Telephone Number	:	315-572-2274
Fax Number	:

Provider Business Practice Location Address
First Line	:	7864 HICKS RD
Second Line	:
City	:	BALDWINSVILLE
State	:	NY
Zip	:	13027-9464
Country	:	US
Telephone Number	:	315-638-6127
Fax Number	:

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

Provider Enumeration Date	:	07/13/2011
Last Update Date	:	06/11/2019

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Directions to “ ASHLEY BIRD MS CCC-SLP” Practice Location

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