MEDICARE: ASHLEY MARTZ MS ED, 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	SL012069	PA

General Provider Information

NPI Number	:	1770987042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MARTZ MS ED, CCC-SLP

Provider Business Mailing Address
First Line	:	104 SPARROW RD
Second Line	:
City	:	HUMMELSTOWN
State	:	PA
Zip	:	17036-8833
Country	:	US
Telephone Number	:	717-433-0530
Fax Number	:

Provider Business Practice Location Address
First Line	:	341 N RAILROAD ST
Second Line	:
City	:	PALMYRA
State	:	PA
Zip	:	17078-1328
Country	:	US
Telephone Number	:	717-838-3011
Fax Number	:

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

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	05/20/2015

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Directions to “ ASHLEY MARTZ MS ED, CCC-SLP” Practice Location

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