Individual
ASHLEY FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3110 OAKBRIDGE BLVD E, LAKELAND, FL 33803-5987
(863) 648-4800
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ6413
FL
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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