MEDICARE: ASHLEE PARKS

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	0133004284	VA

General Provider Information

NPI Number	:	1588450258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEE PARKS

Provider Business Mailing Address
First Line	:	7718 MAIN ST
Second Line	:
City	:	MIDDLETOWN
State	:	VA
Zip	:	22645-9500
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7718 MAIN ST
Second Line	:
City	:	MIDDLETOWN
State	:	VA
Zip	:	22645-9500
Country	:	US
Telephone Number	:	540-431-5641
Fax Number	:

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

Provider Enumeration Date	:	04/17/2025
Last Update Date	:	04/17/2025

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Directions to “ ASHLEE PARKS ” Practice Location

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