Provider Demographics
NPI:1740540459
Name:FLANAGAN, ASHLEE YATES (PHD)
Entity type:Individual
Prefix:MISS
First Name:ASHLEE
Middle Name:YATES
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S INDEPENDENCE MALL W APT 1018
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3425
Mailing Address - Country:US
Mailing Address - Phone:901-896-9858
Mailing Address - Fax:
Practice Address - Street 1:2716 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-2305
Practice Address - Country:US
Practice Address - Phone:267-425-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020080103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist