Provider Demographics
NPI:1861607731
Name:GRYSKIEWICZ, ASHLEY HILLIER (MSCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:HILLIER
Last Name:GRYSKIEWICZ
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OXFORD CT
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2905
Mailing Address - Country:US
Mailing Address - Phone:856-719-8385
Mailing Address - Fax:
Practice Address - Street 1:200 NORTHPOINTE CIR
Practice Address - Street 2:SUITE 302
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7861
Practice Address - Country:US
Practice Address - Phone:800-815-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00338200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist