Individual
MS. ASHLEY ATWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., C.C.C.
Contact information
Practice address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644
Mailing address
602 VONDERBURG DR, SUITE 200, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA7714
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812040400
—
FL
05
—
887859500
—
FL
01
—
S2813
BC/BS OF FLORIDA PROVIDER
FL
Enumeration date
09/12/2006
Last updated
09/12/2011
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