Healthcare Provider Details

I. General information

NPI: 1972426591
Provider Name (Legal Business Name): ASHLEY LUMPKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 450
GRANT FL
32949-0450
US

IV. Provider business mailing address

PO BOX 450
GRANT FL
32949-0450
US

V. Phone/Fax

Practice location:
  • Phone: 321-298-7827
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB1533698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: