Healthcare Provider Details

I. General information

NPI: 1427565316
Provider Name (Legal Business Name): ASHLEY FOURNIER BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HERITAGE DR STE 100
SOUTHGATE MI
48195-3047
US

IV. Provider business mailing address

75 AUTUMN ST
NEWPORT VT
05855-1802
US

V. Phone/Fax

Practice location:
  • Phone: 734-767-2250
  • Fax:
Mailing address:
  • Phone: 802-999-0751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2958
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: