Basic Information
| Provider Information | |||||||||
| NPI: | 1639409857 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUNG | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | FAITH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.S. CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 161 S. WAKEA AVE | ||||||||
| Address2: | |||||||||
| City: | KAHULUI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082447467 | ||||||||
| FaxNumber: | 8082424762 | ||||||||
| Practice Location | |||||||||
| Address1: | 2747 S KIHEI RD | ||||||||
| Address2: | H205 | ||||||||
| City: | KIHEI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967539619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083594762 | ||||||||
| FaxNumber: | 8084196501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2010 | ||||||||
| LastUpdateDate: | 12/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 1229 | HI | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.