Provider Demographics
NPI:1679944391
Name:KROUSE, ASHLEA (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ASHLEA
Middle Name:
Last Name:KROUSE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-5114
Mailing Address - Country:US
Mailing Address - Phone:804-201-9772
Mailing Address - Fax:
Practice Address - Street 1:2708 PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-5114
Practice Address - Country:US
Practice Address - Phone:804-201-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000471103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst