Healthcare Provider Details

I. General information

NPI: 1063331783
Provider Name (Legal Business Name): ASHLEY KENDRA ALCOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 PLEASANT ST STE 100
FALL RIVER MA
02721-3015
US

IV. Provider business mailing address

1163 ROCKDALE AVE
NEW BEDFORD MA
02740-2997
US

V. Phone/Fax

Practice location:
  • Phone: 774-294-5772
  • Fax: 774-294-5724
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: