Individual
ALYSHA ASHBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
23532 STATE ROAD 54, LUTZ, FL 33559-6753
(800) 457-4573
Mailing address
23532 STATE ROAD 54, LUTZ, FL 33559-6753
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY12183
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY12183
FL
Other
Enumeration date
07/11/2024
Last updated
08/15/2024
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