Provider Demographics
NPI:1063829141
Name:HAMBRICK, MARY ASHLEY (M ED, BCBA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ASHLEY
Last Name:HAMBRICK
Suffix:
Gender:F
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19970 ST LOUIS RD
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-4921
Mailing Address - Country:US
Mailing Address - Phone:703-576-5700
Mailing Address - Fax:571-919-6755
Practice Address - Street 1:19970 ST LOUIS RD
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-4921
Practice Address - Country:US
Practice Address - Phone:703-576-5700
Practice Address - Fax:571-919-6755
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0145948103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst