Individual
ASHLYN BROOKE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1727 IMPERIAL BLVD., BLDG #3, LAKE CHARLES, LA 70605-5393
(281) 838-4477
(281) 838-3465
Mailing address
1727 IMPERIAL BLVD., BLDG #3, LAKE CHARLES, LA 70605-5393
(337) 478-5880
(337) 478-5879
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
116945
TX
235Z00000X
Speech-Language Pathologist
Primary
9386
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116945
SLP LICENSE
TX
Enumeration date
08/12/2021
Last updated
10/04/2023
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