Provider Demographics
NPI:1548695760
Name:FELTS, ASHLEY MARIE CAMPBELL (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE CAMPBELL
Last Name:FELTS
Suffix:
Gender:F
Credentials:MS,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:PO BOX 39291
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27438-9291
Mailing Address - Country:US
Mailing Address - Phone:434-250-1503
Mailing Address - Fax:
Practice Address - Street 1:2526 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2333
Practice Address - Country:US
Practice Address - Phone:434-836-9510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9577235Z00000X
VA2202006070235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist