MEDICARE: ASHLEY DIANE DANLEY MA, 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	105013	TX

General Provider Information

NPI Number	:	1598199861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY DIANE DANLEY MA, CCC-SLP

Provider Business Mailing Address
First Line	:	3550 HULEN ST STE D
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6885
Country	:	US
Telephone Number	:	817-377-2535
Fax Number	:	817-292-0572

Provider Business Practice Location Address
First Line	:	3550 HULEN ST STE D
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6885
Country	:	US
Telephone Number	:	817-377-2535
Fax Number	:	817-292-0572

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

Provider Enumeration Date	:	08/22/2013
Last Update Date	:	08/22/2013

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Directions to “ ASHLEY DIANE DANLEY MA, CCC-SLP” Practice Location

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