MEDICARE: ASHLEY KEMMERER M.S., 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	:	1518208578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY KEMMERER M.S., BCBA

Provider Business Mailing Address
First Line	:	5466 VICARIS ST
Second Line	:	APT 2
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2824
Country	:	US
Telephone Number	:	267-772-1206
Fax Number	:	267-772-1206

Provider Business Practice Location Address
First Line	:	5466 VICARIS ST
Second Line	:	APT 2
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2824
Country	:	US
Telephone Number	:	267-772-1206
Fax Number	:	267-772-1206

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

Provider Enumeration Date	:	03/14/2013
Last Update Date	:	11/05/2014

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