Provider Demographics
NPI:1053890665
Name:HURST, ASHLEY (MS,CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:MS,CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 JOE ADLER DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-6801
Mailing Address - Country:US
Mailing Address - Phone:815-651-0532
Mailing Address - Fax:
Practice Address - Street 1:1581 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1952
Practice Address - Country:US
Practice Address - Phone:630-552-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.014437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist