Provider Demographics
NPI:1043761968
Name:THEMIDES, ASHEY TAYLOR (BCABA)
Entity type:Individual
Prefix:
First Name:ASHEY
Middle Name:TAYLOR
Last Name:THEMIDES
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4621 DOGWOOD SPRINGS LN
Mailing Address - Street 2:APT 301
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7640
Mailing Address - Country:US
Mailing Address - Phone:757-971-7266
Mailing Address - Fax:
Practice Address - Street 1:4621 DOGWOOD SPRINGS LN
Practice Address - Street 2:APT 301
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-7640
Practice Address - Country:US
Practice Address - Phone:757-971-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0167354106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst