Provider Demographics
NPI:1144996729
Name:WILKINS, ASHLEY MARIE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:WILKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:ALBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAIDEN NAME
Mailing Address - Street 1:1860 ATKINSON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5066
Mailing Address - Country:US
Mailing Address - Phone:678-442-7861
Mailing Address - Fax:
Practice Address - Street 1:1860 ATKINSON RD STE 101
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5066
Practice Address - Country:US
Practice Address - Phone:678-442-7861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118784235Z00000X
GA012584235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist