=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851184410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY HANNAH BIGNALL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2025
-----------------------------------------------------
Last Update Date | 05/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4243 S CASTLE RIDGE DR SE APT 135
-----------------------------------------------------
City | KENTWOOD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49508-8829
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-240-5973
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4243 S CASTLE RIDGE DR SE APT 135
-----------------------------------------------------
City | KENTWOOD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49508-8829
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-240-5973
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------