Provider Demographics
NPI:1144912965
Name:WATTS, ASHLEIGH MILDRED (SLP-CF)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:MILDRED
Last Name:WATTS
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 MINK AVE # 205
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-6300
Mailing Address - Country:US
Mailing Address - Phone:843-252-0033
Mailing Address - Fax:843-582-0259
Practice Address - Street 1:5000 HIGHWAY 17 BYP S
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-4500
Practice Address - Country:US
Practice Address - Phone:843-252-0033
Practice Address - Fax:843-582-0259
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist