Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY003939 | GA |
N | 103T00000X | Psychologist | PSY003939 | GA |
Y | 102L00000X | Psychologist | PY10343 | FL |
Y | 103T00000X | Psychologist | PY10343 | FL |
N | 103TC1900X | Counseling Psychologist | PSY003939 | GA |
NPI | 1104174473 |
---|---|
Provider Name | Dr. Ashley Gobeil |
First Address | Longwood, FL 32779-4455 |
Second Address | Longwood, FL 32779-4455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2012 |
Last Update Date | 23/01/2020 |