Healthcare Provider Details

I. General information

NPI: 1982190849
Provider Name (Legal Business Name): ASHLEY M PALMER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 JACKSON AVE
WINTER PARK FL
32789-4667
US

IV. Provider business mailing address

1219 SOUTHERLY PARC LN APT 210
ORANGE CITY FL
32763-8099
US

V. Phone/Fax

Practice location:
  • Phone: 407-416-4538
  • Fax:
Mailing address:
  • Phone: 407-416-4538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: