Provider Demographics
NPI:1649640624
Name:ASPER, MARY B (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:B
Last Name:ASPER
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 1:659 CODDING HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON
Mailing Address - State:VT
Mailing Address - Zip Code:05656-9683
Mailing Address - Country:US
Mailing Address - Phone:802-233-5714
Mailing Address - Fax:
Practice Address - Street 1:659 CODDING HOLLOW RD
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:VT
Practice Address - Zip Code:05656-9683
Practice Address - Country:US
Practice Address - Phone:802-233-5714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT144.0116163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist