MEDICARE: ASHLEY ANNMARIE RICHARDSON M.A., 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	SLP10576	AZ

General Provider Information

NPI Number	:	1972027290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ANNMARIE RICHARDSON M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	6731 E GRANADA RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-2511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6731 E GRANADA RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257
Country	:	US
Telephone Number	:	515-418-8497
Fax Number	:

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

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	07/28/2017

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Directions to “ ASHLEY ANNMARIE RICHARDSON M.A., CCC-SLP” Practice Location

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