MEDICARE: ASHLEY RITCHEY BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1467099168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY RITCHEY BCBA

Provider Business Mailing Address
First Line	:	3730 EDISON LAKES PKWY
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-3424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1535 PROVIDENT DR
Second Line	:
City	:	WARSAW
State	:	IN
Zip	:	46580-3294
Country	:	US
Telephone Number	:	574-387-4313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2019
Last Update Date	:	12/02/2019

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Directions to “ ASHLEY RITCHEY BCBA” Practice Location

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