Provider Demographics
NPI:1104174473
Name:GOBEIL, ASHLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:GOBEIL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MALCHOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2941 W SR 434 STE 300
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4415
Mailing Address - Country:US
Mailing Address - Phone:407-756-3930
Mailing Address - Fax:
Practice Address - Street 1:2941 W SR 434 STE 300
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4415
Practice Address - Country:US
Practice Address - Phone:407-756-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-17
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003939103T00000X, 103TC1900X
FLPY10343103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling