Provider Demographics
NPI:1366997405
Name:GARSON, ASHLEY RABIN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RABIN
Last Name:GARSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:JAE
Other - Last Name:RABIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:5044 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2605
Mailing Address - Country:US
Mailing Address - Phone:216-691-2000
Mailing Address - Fax:
Practice Address - Street 1:5044 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2605
Practice Address - Country:US
Practice Address - Phone:216-691-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.11059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist