Healthcare Provider Details

I. General information

NPI: 1487047320
Provider Name (Legal Business Name): ASHLEY MARGENOT HINGSTON M.A., RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY NICOLE MARGENOT

II. Dates (important events)

Enumeration Date: 03/17/2015
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11875 HIGH TECH AVE
ORLANDO FL
32817-1400
US

IV. Provider business mailing address

3023 HELEN AVE
ORLANDO FL
32804-3800
US

V. Phone/Fax

Practice location:
  • Phone: 407-273-8444
  • Fax:
Mailing address:
  • Phone: 954-383-7187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberIMH # 11324
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: