Provider Demographics
NPI:1609136480
Name:YOUNGER, ASHLEE FARINA (MA)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:FARINA
Last Name:YOUNGER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 LAKE BALDWIN LN
Mailing Address - Street 2:UNIT 210
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6954
Mailing Address - Country:US
Mailing Address - Phone:727-418-6555
Mailing Address - Fax:
Practice Address - Street 1:1525 S ALAFAYA TRL
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8926
Practice Address - Country:US
Practice Address - Phone:407-277-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5775235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist