Basic Information
| Provider Information | |||||||||
| NPI: | 1518350909 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCRARY | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | H | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7675 WOLF RIVER CIR | ||||||||
| Address2: | SITE#202 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381381750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017373021 | ||||||||
| FaxNumber: | 9015216405 | ||||||||
| Practice Location | |||||||||
| Address1: | 7675 WOLF RIVER CIR | ||||||||
| Address2: | SITE#202 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381381750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017373021 | ||||||||
| FaxNumber: | 9015216405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2015 | ||||||||
| LastUpdateDate: | 03/10/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | SP0000003801 | 01 | TN | TN LIC | OTHER |