Individual
ASHLEY ANNE BRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
765 ALLENS AVE, SUITE 110, PROVIDENCE, RI 02905-5443
(401) 444-3201
(401) 444-8507
Mailing address
765 ALLENS AVE, SUITE 110, PROVIDENCE, RI 02905-5443
(401) 444-3201
(401) 444-8507
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP01040
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP01040
LICENSE
RI
Enumeration date
12/11/2008
Last updated
11/12/2010
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