Healthcare Provider Details

I. General information

NPI: 1821531799
Provider Name (Legal Business Name): ASHLEY CEDERHOLM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 GREENSBORO STATION PL
MC LEAN VA
22102-3467
US

IV. Provider business mailing address

6800 PARAGON PL STE 200
RICHMOND VA
23230-1652
US

V. Phone/Fax

Practice location:
  • Phone: 317-936-1240
  • Fax:
Mailing address:
  • Phone: 850-420-1699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133002351
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: