Provider Demographics
NPI:1033982871
Name:GILLIS, ASHLEY MONIQUE (MPS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MONIQUE
Last Name:GILLIS
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MONIQUE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-2023
Mailing Address - Country:US
Mailing Address - Phone:914-403-4191
Mailing Address - Fax:
Practice Address - Street 1:138 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-2023
Practice Address - Country:US
Practice Address - Phone:914-403-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst