Healthcare Provider Details

I. General information

NPI: 1457072332
Provider Name (Legal Business Name): ASHLEY PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44125 WOODRIDGE PKWY STE 100
LEESBURG VA
20176-6839
US

IV. Provider business mailing address

44125 WOODRIDGE PKWY STE 100
LEESBURG VA
20176-6839
US

V. Phone/Fax

Practice location:
  • Phone: 718-637-0233
  • Fax: 703-935-1366
Mailing address:
  • Phone: 718-637-0233
  • Fax: 703-935-1366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: