MEDICARE: ASHLEY DEAN 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	119849	TX

General Provider Information

NPI Number	:	1992491344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY DEAN MS, CCC/SLP

Provider Business Mailing Address
First Line	:	5310 N TARRANT PKWY STE 152
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7300
Country	:	US
Telephone Number	:	817-514-6333
Fax Number	:	817-514-6334

Provider Business Practice Location Address
First Line	:	5310 N TARRANT PKWY STE 152
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7300
Country	:	US
Telephone Number	:	817-514-6333
Fax Number	:	817-514-6334

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

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	04/17/2023

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Directions to “ ASHLEY DEAN MS, CCC/SLP” Practice Location

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