Provider Demographics
NPI:1659857126
Name:LAYNE, ASHLEY HARMON (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:HARMON
Last Name:LAYNE
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2208
Mailing Address - Country:US
Mailing Address - Phone:931-455-2518
Mailing Address - Fax:931-393-2455
Practice Address - Street 1:205 S WOODLAND ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355
Practice Address - Country:US
Practice Address - Phone:931-728-5189
Practice Address - Fax:931-728-5180
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6217235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist