Provider Demographics
NPI:1487044574
Name:CHIN, ASHLEY MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MARIE
Last Name:CHIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1709 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3825
Mailing Address - Country:US
Mailing Address - Phone:561-708-0208
Mailing Address - Fax:888-965-1386
Practice Address - Street 1:1709 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3825
Practice Address - Country:US
Practice Address - Phone:561-708-0208
Practice Address - Fax:888-965-1386
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9242103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical