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NPI Code Detail

MEDICARE: ASHLEA KROUSE BCBA, LBA

MEDICARE:   ASHLEA  KROUSE  BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst0133000471VA

General Provider Information

NPI Number : 1679944391
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEA KROUSE BCBA, LBA
Provider Business Mailing Address
First Line : 2708 PARKWOOD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23220-5114
Country : US
Telephone Number : 804-201-9772
Fax Number :
Provider Business Practice Location Address
First Line : 2708 PARKWOOD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23220-5114
Country : US
Telephone Number : 804-201-9772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2015
Last Update Date : 10/08/2015

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Directions to “ ASHLEA KROUSE BCBA, LBA” Practice Location

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