Provider Demographics
NPI:1487409959
Name:DEORDIO, ASHLEY (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DEORDIO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-2121
Mailing Address - Country:US
Mailing Address - Phone:248-289-3104
Mailing Address - Fax:
Practice Address - Street 1:410 W UNIVERSITY DR STE A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1938
Practice Address - Country:US
Practice Address - Phone:248-266-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist