Provider Demographics
NPI:1730700592
Name:BETTERTON, ASHTON
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:BETTERTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 N WASHINGTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2100
Mailing Address - Country:US
Mailing Address - Phone:580-740-0205
Mailing Address - Fax:580-440-5808
Practice Address - Street 1:1705 N WASHINGTON AVE STE C
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2100
Practice Address - Country:US
Practice Address - Phone:580-740-0205
Practice Address - Fax:580-440-5808
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist