Healthcare Provider Details

I. General information

NPI: 1457280315
Provider Name (Legal Business Name): ASHLEY JESSICA MALIN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 SW 34TH AVE STE 905-205
OCALA FL
34474-7447
US

IV. Provider business mailing address

3101 SW 34TH AVE STE 905-205
OCALA FL
34474-7447
US

V. Phone/Fax

Practice location:
  • Phone: 352-790-7910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number023948-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: