Provider Demographics
NPI:1306439633
Name:YOUNG, ASHLEY (SLPA)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13300 SW 16TH CT
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-5711
Mailing Address - Country:US
Mailing Address - Phone:954-258-2474
Mailing Address - Fax:
Practice Address - Street 1:1431 N PALM AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3228
Practice Address - Country:US
Practice Address - Phone:954-443-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI41852355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant