Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0167354 | VA |
NPI | 1043761968 |
---|---|
Provider Name | Ashey Taylor Themides |
First Address | Glen Allen, VA 23059-7640 |
Second Address | Glen Allen, VA 23059-7640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2016 |
Last Update Date | 14/10/2016 |