Healthcare Provider Details

I. General information

NPI: 1619892973
Provider Name (Legal Business Name): ASHLEIGH SANTILLO-YOUNG ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 INDIANOLA RD
BOARDMAN OH
44512-1704
US

IV. Provider business mailing address

835 INDIANOLA RD
BOARDMAN OH
44512-1704
US

V. Phone/Fax

Practice location:
  • Phone: 330-782-3164
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: