Provider Demographics
NPI:1639409857
Name:JUNG, ASHLEY FAITH (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:FAITH
Last Name:JUNG
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 1:161 S. WAKEA AVE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732
Mailing Address - Country:US
Mailing Address - Phone:808-244-7467
Mailing Address - Fax:808-242-4762
Practice Address - Street 1:2747 S KIHEI RD
Practice Address - Street 2:H205
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-9619
Practice Address - Country:US
Practice Address - Phone:808-359-4762
Practice Address - Fax:808-419-6501
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist