Individual
ASHLEY NICOLE HARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 NW 1ST ST, WILLISTON, FL 32696-2053
(352) 286-1928
Mailing address
40 NW 1ST ST, WILLISTON, FL 32696-2053
(352) 286-1928
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA12430
FL
235Z00000X
Speech-Language Pathologist
SZ5816
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005956700
—
FL
Enumeration date
07/05/2012
Last updated
09/17/2013
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